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					Prosthetics Basics
   User Manual




       Version 3.0

       March 2010
Revised August 2011



    Department of Veterans Affairs
VISTA System Design and Development
                    Document Tracking Page – Internal Use Only

                                         Document Control Grid

Document Title           Prosthetics Basic User Manual
Filename                 prostheticsbasicusermanual.doc

                                         Revision History Table

    Date                      Description                       Project Manager     Technical Writer
August 2011      RMPR*3*167, Modify text when                 M Anthony           C Arceneaux
                 referencing Form 1358. See page 88.
3/01/2010        Added new option EDIT 2319 (Vendor,          April Scott         Gary Werner
                 QTY, Cost) RMPR*3*150
5/19/2004        Initial Version 3.0




Revised August 2011               Display/Print in Prosthetics.doc                                     i
Table of Contents


Prosthetics Basics User Manual....................................................................................................1
Section 1: Understanding Main Menu Features ........................................................................1
   Overview ................................................................................................................................................... 1
   Purchasing Menu (PU) .............................................................................................................................. 4
   Purchasing Menu (PU) .............................................................................................................................. 6
   Display/Print Menu (DD).......................................................................................................................... 7
   Utilities Menu (UT) .................................................................................................................................. 8
   Suspense Menu (SU)................................................................................................................................. 9
   Correspondence Menu (CO) ................................................................................................................... 11
   Scheduled Meetings and Home/Liaison Visits Menu (SC) .................................................................... 12
   Process Form 2529-3 (PS) ...................................................................................................................... 13
   Eligibility Inquiry (EL) Menu ................................................................................................................. 14
   PSC/Entitlement Records (ET) Menu ..................................................................................................... 17
   Home Oxygen Main Menu (HO) ............................................................................................................ 18
   Pros Inventory Main (INV) ..................................................................................................................... 20
   NPPD Tools Menu (ND)......................................................................................................................... 22
Section 2: Display/Print Menu ...................................................................................................25
   Overview ................................................................................................................................................. 25
   Display/Print Menu Option Descriptions ................................................................................................ 26
   Display/Print Patient 2319 (23)............................................................................................................... 27
   View and Print the Patient 2319.............................................................................................................. 28
   View Patient Demographics.................................................................................................................... 30
   View Clinic Enrollments/Correspondence .............................................................................................. 31
   View Letters/Correspondence on File..................................................................................................... 32
   View Entitlement Information ................................................................................................................ 34
   View Appliance Transactions ................................................................................................................. 35
   View Auto Adaptive Information ........................................................................................................... 37
   View Critical Comments ......................................................................................................................... 38
   Add/Edit Disability Codes ...................................................................................................................... 39
   View Home Oxygen Items ...................................................................................................................... 42
Transaction Inquiry (TI) .............................................................................................................43
   View a Transaction ................................................................................................................................. 43
Print All Prosthetic Items (IP) ....................................................................................................45
   Overview ................................................................................................................................................. 45
   View the Prosthetic Item Master List...................................................................................................... 46
Print Prosthetic Billings for MAS (BI).......................................................................................47
   Overview ................................................................................................................................................. 47
   View Prosthetic Billing Information ....................................................................................................... 48
Item History (IH) .........................................................................................................................50
   View Item History................................................................................................................................... 50
   View Item History Within a Date Range ................................................................................................ 51
Search for Recalled Item (SE) ....................................................................................................52
   Overview ................................................................................................................................................. 52
   Search by Serial Number or Lot Number ............................................................................................... 53
   Search by Item Number .......................................................................................................................... 54



Revised August 2011                                Display/Print in Prosthetics.doc                                                                           ii
Site Parameter Inquiry (SI) ........................................................................................................56
   Overview ................................................................................................................................................. 56
Vendor Inquiry (VI) ....................................................................................................................57
   Overview ................................................................................................................................................. 57
   Vendor Inquiry Screen Output ................................................................................................................ 58
Section 3: Purchasing Menu (PU) .............................................................................................59
   Overview ................................................................................................................................................. 59
   List Open 1358 Prosthetic Transactions (LI) .......................................................................................... 62
   Close Out (CO) ....................................................................................................................................... 64
Enter New Request (EN) .............................................................................................................65
   Overview ................................................................................................................................................. 65
   Enter a 2421 Form (24) ........................................................................................................................... 66
   Enter a 2520 Transaction without Printing 10-55 (25) ........................................................................... 76
   10-55 PSC Form (10) .............................................................................................................................. 78
   2914 Eyeglass Record (29) ..................................................................................................................... 81
Appendix A – Online Help ..........................................................................................................83
Appendix B - Glossary .................................................................................................................84




Revised August 2011                                Display/Print in Prosthetics.doc                                                                         iii
                           Prosthetics Basics User Manual
            Section 1: Understanding Main Menu Features
Overview


Audience              The Prosthetics Basics User Manual is for new Prosthetics users of the Prosthetics
                      Sensory Aids Service (PSAS) system including Purchasing Agents and any other
                      new end user on the system.

                      This manual will provide a general overview of the entire system as well as step-by-
                      step instructions of the more frequently used menus and options.


Main Menu             The main menu for Prosthetics is the following - the Prosthetic’s Officials Menu:

                                      Prosthetic’s Officials Menu
                          PU      Purchasing
                          DD      Display/Print
                          UT      Utilities
                          AM      AMIS
                          SU      Suspense
                          CO      Correspondence
                          SC      Scheduled Meetings & Home/Liaison
                          PS      Visits Form 2529-3
                                  Process
                          EL      Eligibility Inquiry
                          ET      PSC/Entitlement Records
                          HO      Home Oxygen Main Menu
                          INV     Pros Inentory Main
                          ND      NPPD Tools
                          VR      Verify/Repair Purchase Card Form



In this manual        The following are the sections in this manual.

                                                   Topic                                       See Page
                      Section 1: Understanding Main Menu Features                                  1
                      Section 2: Display/Print Menu (DD)                                          24
                      Section 3: Purchasing Menu (PU)                                             58
                      Appendix A – Online Help                                                    82
                      Appendix B - Glossary                                                       83

                                                                                      Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                      1
Overview, Continued


Menu Options          Below are the Prosthetic Official’s Main Menu options, the option name for each,
                      the synonym, and a description of each. To display this information, type three
                      question marks at the following prompt:

                      Select Prosthetic Official's Menu Option: ??? <Enter>

                        Menu Option      Synonym        Option                       Description
                                                        Name
                      Purchasing         PU          RMPR      Purchasing menu, sub-menu of
                                                     PURCHAS-  Prosthetic Clerk/Official master
                                                     ING MENU  menus.
                      Display/Print      DD          RMPR      Display/Print menu for Prosthetic
                                                               Clerks and Officials. This is a sub-
                                                     DISPLAY/PRI
                                                     NT        menu of Prosthetic Clerks and
                                                               Official’s master menus.
                      Utilities          UT          RMPR      This is the Prosthetic’s Utility
                                                     UTILITIES Menu.
                      AMIS               AM          RMPR MGMT AMIS data is generated from this
                                                     REPORTS   menu option.
                      Suspense           SU          RMPR      This is the menu for Suspense
                                                     SUSPENSE  Options.
                                                     MENU
                      Correspondence     CO          RMPR CORR This is the main menu for
                                                     MAIN      Correspondence.
                      Scheduled          SC          RMPR      This is the main menu for
                      Meetings &                     SCHED-H/L Scheduled Meetings and Home
                      Home/Liaison                   VISITS    Liaison Visits.
                      Visits
                      Eligibility        EL          RMPR ELG            This option is an eligibility inquiry
                      Inquiry                        INQ                 into the MAS PATIENT file (#2).
                      PSC/               ET          RMPR                This is the menu for Prosthetic
                      Entitlement                    ENTITLE-            Service Card and Entitlement
                      Records                        MENT/PSC            Records.
                      Home Oxygen        HO          RMPO-               This menu helps you manage your
                      Main Menu                      MENU-MAIN           home oxygen program. It tracks
                                                                         costs of services, helps you manage
                                                                         billings, and alerts you when it is
                                                                         time to send letters to patients (e.g.,
                                                                         prescription expiration).
                      NPPD Tools         ND          RMPR NPPD           This option contains all tools
                                                     TOOLS               associated with the National
                                                                         Prosthetic Patient Database.

                                                                                         Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                             2
Overview, Continued


Menu Options          Below are the Prosthetic Official’s Main Menu options, the option name for each,
(continued)           the synonym, and a description of each.


                        Menu Option       Synonym         Option                   Description
                                                           Name
                      Process Form        PS          RMPR 2529-3        Main Menu for Prosthetics Lab
                      2529-3                          MAIN               Module
                      Pros Inventory      INV         RMPR INV           Prosthetic generic inventory
                      Main                            MAIN               system.
                      NPPD Tools          ND          RMPR NPPD          Tools for the National
                                                      TOOLS              Prosthetics Patient Database
                      Verify/Repair       VR          RMPR Verify/       Temporary option used to fix
                      Purchase Card                   Repair PC          reconciliations of Purchase Card
                      Form                            Number             orders.




Revised August 2011                     Prosthetics Basics User Manual                                      3
Purchasing Menu (PU)


Menu option           Below are the Purchasing Menu (PU) options, the synonym, option name and a
descriptions          description of each.

                           Menu Option          Synonym        Option             Description
                                                               Name
                      Enter New Request         EN           RMPR ENT    This is the sub-menu for
                                                             REQUESTS    entering prosthetic
                                                                         purchasing requests that link
                                                                         with IFCAP.
                      Stock Issues              SI           RMPR        This is the Stock Issue Menu
                                                             STOCK ISS   Options.
                      Reprints                  RP           RMPR        This is the Reprint Menu for
                                                             REPRINTS    Prosthetic Purchasing Forms.
                      Record 2237 Purchase to RE             RMPR ENT    This option will record the
                      10-2319                                2237        information from a VAF
                                                                         2237 to a patient’s VAF
                                                                         10-219 record.
                      Edit/Delete 2237 from     ED           RMPR 2319   This option will edit or delete
                      10-2319                                EDT         information posted from a
                                                                         VAF 2237 record to a
                                                                         patient’s VAF 10-2319.
                      Cancel a Transaction      CA           RMPR        This option will cancel
                                                             CANCEL      purchasing transactions that
                                                                         have not been closed out.
                      Close Out                 CO           RMPR        This is locked with
                                                             CLOSE-      RMPRSUPERVISOR. This
                                                             OUT         option is used to close out
                                                                         transactions when invoices
                                                                         are received from the vendor.
                                                                         This will update the actual
                                                                         VAF 1358 account balance.
                      Cancel Purchase Card      CPC          RMPR4       This option will cancel the
                      Transaction                            PCC         Purchase Card Transaction
                                                                         and remove the purchase
                                                                         from the Patient’s 10-2319
                                                                         Record.
                      Reconcile/Close Out       CPO          RMPR4       This option is used to close
                      Purchase Card                          CLOSE       out purchasing transactions
                      Transaction                            OUT         that used the Purchase Card.
                                                                         This option will not post to
                                                                         IFCAP 1358.

                                                                                  Continued on next page




Revised August 2011                    Prosthetics Basics User Manual                                  4
Purchasing Menu (PU), Continued


Menu option           Below are the Purchasing Menu (PU) options, the synonym, option name and a
descriptions          description of each.
(continued)

                           Menu Option            Synonym       Option           Description
                                                                 Name
                      Edit 2319                   ED2         RMPR EDIT This option will allow limited
                                                              2319      editing of purchasing and
                                                                        stock issue transactions
                                                                        recorded on a patient’s VAF
                                                                        10-2319.
                      EDIT 2319 (Vendor,          ED2C        RMPR EDIT This option will allow users
                      QTY, Cost)                              2319      with the
                                                              VENDOR/Q RMPRSUPERVISOR key to
                                                              TY/COST   edit Vendor, Qty & cost.

                      Edit Purchase Card          EDPC        RMPR4        This option will edit the
                      Transaction                             EDPC         2421PC form once it has
                                                                           been created.
                      Add Historical Data         HI          RMPR HIS     This option will allow
                                                              DATA         posting an item to the
                                                                           patient’s VAF 10-2319
                                                                           without counting on AMIS.
                      Delete Historical Data      HID         RMPR HIS     This option deletes historical
                                                              DEL          data.
                      List Open 1358              LI          RMPR         This option lists VAF 1358
                      Prosthetic Transactions                 PRINT        transactions that have not
                                                              OPEN         been closed out.
                                                              TRANS
                      List Open 1358              LII         RMPR         This option will print open
                      Transactions by Initiator               PRINT        1358 transactions in the
                                                              OPEN         Prosthetics package, sorted
                                                              TRANS        by initiator.
                                                              INIT
                      List Open Purchase Card LPC             RMPR4        This menu will print all open
                      Transactions                            LIST OPN     Purchase Card Transactions.
                                                                           The Purchase Card Number
                                                                           will be encrypted, except for
                                                                           the creator and supervisor.
                      List Open Purchase Card LPCI            RMPR4        This option will print the
                      Transactions by Initiator               LIST OPEN    open Purchase Card
                                                              BY INIT      Transactions by Initiator,
                                                                           sorted by transaction date.




Revised August 2011                     Prosthetics Basics User Manual                                      5
Purchasing Menu (PU)


Menu option           Below are the Purchasing Menu (PU) options, the synonym, option name and a
descriptions          description of each.

                           Menu Option          Synonym        Option            Description
                                                               Name
                      Purchase Card Summary     LPS          RMPR4 PC    This option displays the
                      Sheet                                  SUM         Purchase Card Summary by
                                                                         Card Number. It will list the
                                                                         open and closed obligations.




Revised August 2011                    Prosthetics Basics User Manual                                    6
Display/Print Menu (DD)


Menu option           Below are the Display/Print Menu (DD) options, the synonym, option name and a
descriptions          description of each.

                           Menu Option            Synonym        Option           Description
                                                                  Name
                      Display/Print Patient       23           RMPR       Display/print a patient's VAF
                      2319                                     PRINT 2319 10-2319.

                      Transaction Inquiry         TI           RMPR 1358     Inquiry to single purchasing
                                                               INQ           transaction.

                      Print All Prosthetic Items IP            RMPR          This option prints all
                                                               PRINT ALL     Prosthetic Item Master
                                                               ITEMS         records along with their new
                                                                             and repair AMIS codes. Lab
                                                                             AMIS codes are not printed
                                                                             with this version of
                                                                             Prosthetics.

                      Print Prosthetic Billings   BI           RMPR       Prints all NSC (non-service
                      for MAS                                  PRINT BILL connected) items issued to
                                                                          patients for billing purposes.

                      Item History                IH           RMPR          Prints an item history of all
                                                               ITEM          purchases made for this item.
                                                               HISTORY
                      Search for Recalled Item    SE           RMPR          Searches the RECORD OF
                                                               PRINT         PROS APPLIANCE/
                                                               RECALL        REPAIR file (#660) for
                                                                             recalled item.

                      Site Parameter Inquiry      SI           RMPR SITE This menu option should be
                                                               INQ       used to review your local site
                                                                         information.

                      Vendor Inquiry              VI           RMPR INQ      This option is an inquiry to
                                                               VEND          the IFCAP VENDOR file
                                                                             (#440).




Revised August 2011                      Prosthetics Basics User Manual                                      7
Utilities Menu (UT)


Menu option           Below are the Utilities Menu options, the synonym, option name and a description
descriptions          of each.


                            Menu Option          Synonym        Option            Description
                                                                 Name
                      Add/Edit Patient to        AP           RMPR ADD This option will add a new
                      Prosthetics                             PATIENT   patient to the
                                                                        PROSTHETICS PATIENT
                                                                        file (#665). You may also
                                                                        edit existing patient data
                                                                        using this option.
                      Enter Prosthetic           DIS          RMPR DIS  This will add or delete
                      Disability Code to 2319                 ENTRY     Disability Codes to be
                                                                        counted on AMIS.
                      Delete Prosthetic          REM          RMPR DEL Mark Disability Code from
                      Disability Code from                    CODE      patient's VAF 10-2319 as
                      2319                                              deactivated.
                      Enter/Edit Prosthetic      EN           RMPR ADD This option adds a new Item
                      Item Master                             ITEM      Record to File 661, PROS
                                                              MASTER    ITEM MASTER.
                      IFCAP Utilities            IF           RMPR      Menu for IFCAP Vendor and
                                                              VEN/ITEM Item Edit options.
                      Purge Obsolete Data        PGE          RMPR      This is the Purge Menu.
                                                              PURGE
                                                              MENU
                      Flag Item as               RC           RMPR      This will place items as
                      Returned/Condemned                      RETURN    returned, condemned, turned-
                                                                        in, lost or broken. To review
                                                                        this data once entered, review
                                                                        the patient's VAF 10-2319
                                                                        record on the third screen.
                      Edit Returned/             RE           RMPR      This option will allow users
                      Condemned Item                          RETURNED to edit or delete items that
                                                              EDIT      have been flagged as returned
                                                                        or condemned.
                      Enter/Edit Site            SP           RMPR SITE To enter/edit station
                      Parameters                              MENU      Prosthetics site parameters.




Revised August 2011                     Prosthetics Basics User Manual                                   8
Suspense Menu (SU)


Menu option           A Suspense Request (through the Suspense Menu) is a request for service or an item
descriptions          that is tracked by a five-day Delayed Order Report. The five workday policy refers
                      to the process or time it takes from receiving the order in Prosthetics to the time an
                      initial action on a request or the time the request is fulfilled has been taken.

                      If this process takes more than five workdays, it is flagged on the report for
                      monitoring and reporting purposes. It is also denoted in the Suspense list by an
                      asterisk.


Menu option           Below are the Suspense Menu options, the synonym, option name and a description
descriptions          of each.

                            Menu Option          Synonym        Option          Description
                                                                Name
                      Add Suspense Record        AS           RMPR ADD Adds a new Suspense Record
                                                              SUSPENSE to the PROSTHETIC
                                                                       SUSPENSE file (#668). The
                                                                       patient need not be in the
                                                                       PROSTHETICS PATIENT
                                                                       file (#665).

                      Close Suspense Record      CS           RMPR           This will close out the
                                                              CLOSE          suspense record, and flag it
                                                              SUSPENSE       as completed.

                      Edit Suspense Record       ES           RMPR           This option will edit a
                                                              SUSPENSE       suspense record for a patient.
                                                              EDIT
                      Inquire to Individual      IS           RMPR INQ       This option will display the
                      Suspense Record                         SUSPENSE       complete Suspense Record
                                                                             for a veteran.

                      Print Closed Suspense      PC           RMPR           This will print the closed
                      Records                                 SUSPENSE       suspense records for a date
                                                              PRINT          range.
                                                              CLOSED
                      Print Open Suspense        PO           RMPR           This option will list all open
                      Records                                 SUSPENSE       suspense records.
                                                              PRINT

                                                                                       Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                        9
Suspense Menu (SU), Continued


Menu option           Below are the Suspense Menu options, the synonym, option name and a description
descriptions          of each.
(continued)

                            Menu Option           Synonym       Option            Description
                                                                 Name
                      Print 5 Day Old             PR          RMPR        This option prints all
                      Suspense Report                         SUSPENSE    suspense records over 5
                                                              PRINT 5     working days old.
                                                              DAY OLD
                      Print Suspense Statistics   ST          RMPR        Prints statistics from the
                                                              SUSPENSE    PROSTHETICS SUSPENSE
                                                              STAT        file (#668).

                      Suspense Processing         SP          RMPR        This is the List Manager
                                                              SUSP        version of Suspense
                                                              MENU        Processing, to be used with
                                                                          Consult Tracking.




Revised August 2011                     Prosthetics Basics User Manual                                  10
Correspondence Menu (CO)


Menu option           Below are the Correspondence Menu options, the synonym, option name and a
descriptions          description of each.

                           Menu Option           Synonym        Option             Description
                                                                Name
                      Create a Letter            CR           RMPR         Creates new letter for
                                                              CORR         Prosthetics.
                                                              CREATE
                      Delete Patient             DE           RMPR         Deletes correspondence letter
                      Correspondence Letter                   CORR         from the PROS LETTER
                                                              DELETE       TRANSACTION file
                                                                           (#665.4).

                      Add/Edit                ED              RMPR      This option allows
                      Correspondence Skeleton                 CORR EDIT Prosthetics managers to edit
                      Letter                                            the basic skeleton letters
                                                                        (FORM LETTER TYPE).

                      Print/Display Patient      PR           RMPR         View correspondence letter.
                      Correspondence Letter                   CORR
                                                              VIEW
                      Print Correspondence       PS           RMPR         Allows printing of a
                      Skeleton Letter                         CORR         correspondence letter.
                                                              PRINT




Revised August 2011                     Prosthetics Basics User Manual                                   11
Scheduled Meetings and Home/Liaison Visits Menu (SC)


Menu option           Below are the Scheduled Meetings and Home/Liaison Visits (SC) Menu options,
descriptions          the synonym, option name and a description of each.

                           Menu Option           Synonym        Option              Description
                                                                 Name
                      Pull over Scheduled        PL           RMPR         This option will allow
                      Clinic Visits                           PULL         scheduling clinic visits to be
                                                              SCHED        pulled over to VAF 10-2527.
                      Edit Form 10-2527          25           RMPR EDIT    Enter referral and action
                      Information                             2527         information to patient's clinic
                                                                           visits.

                      Delete Scheduled           DL           RMPR      This option will allow the
                      Prosthetic Clinic Visits                SCHED     user to delete Prosthetics
                                                              DEL       clinic visits that have been
                                                                        pulled over to the VAF 10-
                                                                        2527.
                      Enter/Edit Closed Time     CA           RMPR      Clinic team member may
                      for Clinic Visits                       CLOSE APP enter or change time that a
                                                                        scheduled clinic appointment
                                                                        was actually completed.

                      Appointment Roster and     AP           RMPR PRT     Prints VAF 10-2527 for
                      Action Sheet                            2527         single clinic after information
                                                                           has been pulled over from
                                                                           MAS scheduled clinic visits.

                      Open Home/Liaison          OP           RMPR H/L     Open home or liaison visits
                      Visits                                  OPEN         for Prosthetics.

                      Close Home/Liaison         CO           RMPR H/L     Close open home or liaison
                      Visits                                  CLOSE        visits by entering the date
                                                                           closed and the total hours of
                                                                           the visit.

                      Edit/Delete                ED           RMPR H/L     Edit/delete home or liaison
                      Home/Liaison Visits                     EDIT         visits.
                      Print Closed               PC           RMPR H/L     Print closed home/liaison
                      Home/Liaison Visits                     PRINT        visits.
                                                              CLOSED
                      Print Open                 PO           RMPR H/L     Print open home or liaison
                      Home/Liaison Visits                     PRINT        visits.
                                                              OPEN




Revised August 2011                     Prosthetics Basics User Manual                                     12
Process Form 2529-3 (PS)


Menu option           Below are the Process Form 2529-3 Menu options, the synonym, option name and a
descriptions          description of each.

                           Menu Option          Synonym        Option            Description
                                                               Name
                      2529-3 Request Menu       RQ           RMPR 2529- This menu will be used by
                                                             3          the Prosthetics administrative
                                                                        personnel to enter, edit, print
                                                                        and close out VAF 10-2529-3
                                                                        requests.

                      Prosthetic Lab Menu       LB           RMPR LAB      This is the main menu for
                                                             MENU          Prosthetic Laboratory
                                                                           Technicians.




Revised August 2011                    Prosthetics Basics User Manual                                  13
Eligibility Inquiry (EL) Menu


Menu option           The Eligibility Inquiry is an option and does not have submenu options. The
descriptions          following is an example of this option


Screen sample            PU     Purchasing ...
                         DD     Display/Print ...
                         UT     Utilities ...
                         AM     AMIS ...
                         SU     Suspense ...
                         CO     Correspondence ...
                         SC     Scheduled Meetings and Home/Liaison Visits ...
                         PS     Process Form 2529-3 ...
                         EL     Eligibility Inquiry
                         ET     PSC/Entitlement Records ...
                         HO     Home Oxygen Main Menu ...
                         INV    Pros Inventory Main ...
                         ND     NPPD Tools ...
                         OC     CoreFLS Order Control
                         VR     VERIFY/REPAIR PURCHASE CARD NUMBER

                      Select Prosthetic Official's Menu Option: EL <Enter> Eligibility Inquiry
                      SITE: Hines Development System//
                      Select PATIENT NAME:    PROSPATIENT,ONE    1-1-30    000000001     NO          PILL

                       Enrollment Priority:              Category: IN PROCESS       End Date:

                                    *** Patient Requires a Means Test ***
                                    Primary Means Test Required from FEB 13,2002

                      Enter <RETURN> to continue.     <Enter>

                      PROSPATIENT,ONE             SSN:000-00-0001   DOB: JAN 1,1930      CLAIM#

                      Phone: PHONE                               Phone:
                      Current Address:                           Primary Next of Kin Address:
                      1ST LINE OF STREET ADDRESS
                      SECOND LINE OF STREET ADDRESS

                      Patient Type: PILL                         Period of Service: OTHER OR NONE
                      Primary Eligibility Code:                  Status: REQUIRED
                      NSC                                        Eligibility Status:

                      Receiving A&A Benefits? NO                 Receiving Housebound Benefits? NO
                      Receiving Social Security? NO              Receiving VA Pension? NO
                      Receiving Military Retirement? NO          Receiving VA Disability? NO

                      Patient Name: PROSPATIENT,ONE              SSN: 000-00-0001

                      MAS Disability Code(s):

                      *POW? NO
                      Enter `^`to exit, or `return` to continue:         <Enter>


                                                                                      Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                   14
Eligibility Inquiry (EL) Menu, Continued


Example               The Eligibility Inquiry also provides Last Movement Actions, Pending
(continued)           Appointments, and letters on file. You can select a Letter on File to be viewed.
                      Enter the number of the letter to display and press <Enter> at the Device prompts.


Screen sample         PROSPATIENT,ONE     SSN: 000-00-0001      DOB: JAN 1,1930   CLAIM#
(continued)                               Last Movement Actions
                      Trans. Type: TRANSFER                   Trans. Type: ADMISSION
                      Date: SEP 11,1995@15:04:29              Date: SEP 11,1995@14:59:18
                      Type of Movement:                       Type of Movement:
                      INTERWARD TRANSFER                      DIRECT
                      Ward: 1AS                               Ward: 5NM
                      Physician: PROSPROVIDER,ONE             Physician: PROSPROVIDER,TWO
                      Diagnosis: SICK                         Diagnosis: SICK
                                          Clinic Enrollments
                      Clinic                                  Enrollment Date     OPT or AC
                      MCGILL,TEST                             MAR 21,2000@13:11      OPT

                                          Pending Appointments
                      Appt. Date          Clinic                           Status    Type
                      MAR 1,2004@09:15    PROSTHETICS                      INPATIENT APPOINTMENTREGULAR
                      SITE: Hines Development System//

                      Letters on file:

                      #    Patient                Type of letter   Employee          Date of letter
                      ------------------------------------------------------------------------------
                      1    PROSPATIENT,ONE    TEST            PROSPROVIDER,THREE        JUN 03, 2003
                      2    PROSPATIENT,ONE    ADP FL 10-90    PROSPROVIDER,THREE        JUN 02, 2003
                      3    PROSPATIENT,ONE    TEST            PROSPROVIDER,THREE        FEB 08, 2002
                      4    PROSPATIENT,ONE    HO 30 DAY TEST PROSPROVIDER,THREE         FEB 08, 2002
                      5    PROSPATIENT,ONE    HO 30 DAY TEST PROSPROVIDER,THREE         FEB 08, 2002

                      Enter '^' to stop or
                      Enter a number (1-5): 2    <Enter>
                      DEVICE: HOME// <Enter>     TELNET     Right Margin: 80//<Enter>


                                                                                    Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                15
Eligibility Inquiry (EL) Menu, Continued


Letter on File        Below is the Letter on File that you selected to view for the specific patient
                      displayed.


Screen sample                                        REQUEST FOR QUOTATION
                                                        Date: Feb 12, 2004
(continued)
                           TO:                                            FROM: PROSVENDOR,ONE
                                                                                Hines Development System
                                                                                TEST 2
                                                                                HINES, IL 60142

                                 Vendor Phone #:                               Veteran: PROSPATIENT,ONE
                                                                                SSN:    000000001

                           Your firm is being considered for the following:

                           An estimate on the above-listed item(s) is requested. YOUR QUOTATION
                           DOES NOT CONSTITUTE A PURCHASE ORDER. Upon completion of the esti-
                           mate, return the original to the Veterans Affairs facility indicated
                           above and retain a copy for your files.

                           If approved, a purchase order will be prepared and forwarded to you.

                           Sincerely,



                           PROSPROVIDER,FOUR
                           CHIEF




Screen sample                                      VENDOR'S ESTIMATE
                                                (To be completed by Vendor)
(continued)                ----------------------------------------------------------------------
                           |      Article or Service       |Quantity| Unit |Unit Cost|Total Cost|
                           ----------------------------------------------------------------------
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           ----------------------------------------------------------------------
                           | Vendor:                            Contract number (if applicable) |
                           | Address:                                                           |
                           | City:                                                              |
                           | State:             Zip:                                            |
                           | Telephone:                                                         |
                           | Date:                         Signature & Title of Company Official|
                           | Note:List Terms/Discounts if Applicable                            |
                           ----------------------------------------------------------------------
                                                                                 FL 10-90 ADP

                      Would you like to see more letters? No//   (No)
                      Do you wish to create a correspondence letter? No//          (No)




Revised August 2011                      Prosthetics Basics User Manual                                    16
PSC/Entitlement Records (ET) Menu


Menu option           Below are the PSC/Entitlement Records (ET) Menu options, the synonym, option
descriptions          name and a description of each.

                           Menu Option           Synonym        Option              Description
                                                                Name
                      Add/Edit Clothing          AC           RMPR         Adds a Clothing Allowance
                      Allowance                               CLOTHING     for a patient.

                      Add/Edit Prosthetic        PS           RMPR ADD This option will add a
                      Service Card                            PSC      Prosthetic Service Card to the
                                                                       patient’s VAF 10-2319
                                                                       record.

                      Enter/Edit Auto            AU           RMPR         This option is the main menu
                      Adaptive Info                           AUTO         to enter/edit auto-adaptive
                                                                           equipment purchased for the
                                                                           patient.

                                                                           This allows adding a new
                                                                           Vehicle of Record, adding
                                                                           van modifications, new
                                                                           items, and editing of items
                                                                           and repairs.

                      Record Other Patient       RO           RMPR ADD This option allows a free-text
                      Information                             OD       word processing area for
                                                                       storage of other information
                                                                       needed by service on the
                                                                       patient's VAF 10-2319
                                                                       record.

                                                                           Information such as eye
                                                                           color, hair color, patient's
                                                                           station, etc. is included.




Revised August 2011                     Prosthetics Basics User Manual                                    17
Home Oxygen Main Menu (HO)


Menu option           Below are the Home Oxygen Main Menu (HO) options, the synonym, option name
descriptions          and a description of each.

                           Menu Option             Synonym       Option               Description
                                                                 Name
                      Add/Edit Home Oxygen        ED           RMPO          This option allows the user to
                      Patient                                  ADD/EDIT      add patients to the Prosthetics
                                                               PAT           Patient file, edit
                                                                             demographics (e.g., therapy
                                                                             activation date and eligibility
                                                                             for home oxygen services),
                                                                             and document prescription
                                                                             and billing equipment data.

                      Billing Transactions        BT           RMPO          This option allows you to
                                                               BILLING       edit bills for a specific
                                                               TRANSACT      month, accept those
                                                               IONS          transactions, and post them.

                      Generate Letters            LE           RMPO       This option creates a list of
                                                               LIST/PRINT patients who are due to
                                                               MANAGER receive letters and prints the
                                                                          letters.

                      Home Oxygen Patient         TU           RMPO HO       This is a utility for updating
                      Template Update                          PAT           vendor, HCPCS, FCP, item,
                                                               TEMPLATE      and unit cost of all Home
                                                               UPDA          Oxygen patients in a
                                                                             particular station at once.

                                                                             Only the patient template is
                                                                             changed, not the monthly
                                                                             billing. If the monthly billing
                                                                             is already been created for a
                                                                             certain month, changes on
                                                                             the template will not affect
                                                                             the billing cycle.


                                                                                      Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                       18
Home Oxygen Main Menu (HO), Continued


Menu option           Below are the Home Oxygen Main Menu (HO) options, the synonym, option name
descriptions          and a description of each.

                           Menu Option           Synonym        Option           Description
                                                                 Name
                      Inactivate/Activate        IN           RMPO      This is an option to
                      Oxygen Patient                          INACT/ACT deactivate and
                                                                        activate/reactivate home
                                                                        oxygen patients.

                      Purchase Card Sign Off     SO           RMPO PO       Once a billing is accepted
                                                              SIGN OFF      and posted, this option can be
                                                                            used to sign off on the
                                                                            billing.

                      Reports                    RE           RMPO-RPT- This menu contains reports
                                                              MAINMEN on active and inactive home
                                                              U         oxygen patients, addresses,
                                                                        prescription reports, billing
                                                                        discrepancies, etc.

                      Site Parameters            SI           RMPO SITE This option is used to define
                      Enter/Edit                              EE        those parameters specific to
                                                                        the site such as: letters that
                                                                        should be generated and
                                                                        default prescription
                                                                        expiration dates.

                      Verify Posted Billing      PB           RMPO          This option posts all Home
                      Transactions                            POST 2319     Oxygen billing transactions
                                                                            for a selected month for bills
                                                                            posted in IFCAP but not in
                                                                            Patient 2319 records. It will
                                                                            loop through all the records
                                                                            for the MONTH and
                                                                            VENDOR entered.




Revised August 2011                     Prosthetics Basics User Manual                                   19
Pros Inventory Main (INV)


Menu option           Below are the Pros Inventory Main (INV) Menu options, the synonym, option
descriptions          name and a description of each.


                           Menu Option             Synonym        Option            Description
                                                                  Name
                      Add Inventory                AE           RMPR INV   This is an option to add a
                      LOCATION or ITEMS                         ADD        Location, HCPCS or ITEMS
                                                                           for inventory. Users can edit
                                                                           item fields under this option.

                      Deactivate Inventory         DE           RMPR INV   This option is only given to
                      Location                                  DEACTIVA   the holder of
                                                                TE         RMPRMANGAER key. It
                                                                           requires the electronic
                                                                           signatures of 2 users holding
                                                                           this key to be entered before
                                                                           a location can be deactivated.

                      Edit Inventory Items         EI           RMPR INV   This option is for editing an
                                                                EDIT       Inventory Location or Items.
                                                                           You can only edit an Item or
                                                                           Location that has already
                                                                           been set-up.

                      Edit Inventory Location      EL           RMPR INV   This option is for editing an
                                                                EDIT       existing inventory location.
                                                                LOCATION
                      Inventory Reports            RP           RMPR INV   Various Inventory reports are
                                                                REPORTS    available through this option.

                      Order Item from Supply       OI           RMPR INV   This is an option to record
                      or Vendor                                 ORDER      that an Item has been
                                                                           ordered. This option will not
                                                                           automatically order an item
                                                                           from Supply or Vendor.


                                                                                    Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                   20
Pros Inventory Main (INV), Continued


Menu options          Below are the Pros Inventory Main (INV) Menu options, the synonym, option
continued             name and a description of each.


                          Menu Option          Synonym          Option             Description
                                                                Name
                      Receive Item from      RC               RMPR       This is an option to record that
                      Supply, Vendor or                       INV        an Item has been received and
                      Patient                                 RECEIVE    entered into the Prosthetics
                                                                         Inventory. Receiving an Item
                                                                         in Supply through the IFCAP
                                                                         package does not update the
                                                                         Prosthetics Inventory module.
                                                                         This option has to be done
                                                                         separately for an Item to be
                                                                         received and recorded in the
                                                                         Prosthetics module.

                      Reconcile Item         UP               RMPR       This is an option to reconcile or
                      Balance                                 INV        update Items in Prosthetics
                                                              RECON-     Inventory. Users can update
                                                              CILE       the Quantity, Total Cost,
                                                                         Vendor, Unit of Issue, Re-order
                                                                         Level and Description.

                      Remove/Deactivate      RE               RMPR       This option removes/
                      HCPCS/Item from                         INV        deactivates inventory item(s)
                      Inventory                               REMOVE     from the Prosthetics Inventory
                                                              HCPCS/     Program. Once an item has
                                                              ITEM       been removed/ deactivated, that
                                                                         item is not accessible. Only
                                                                         users with RMPRMANAGER
                                                                         key can access this option.

                      Transfer Stock         TR               RMPR       This is an option to transfer an
                      Between Locations                       INV        Item to a different Location. In
                                                              TRAN       order to transfer an Item, it
                                                                         must be set-up to both
                                                                         Locations. User can transfer all
                                                                         Quantities or certain
                                                                         Quantities. This option does
                                                                         not remove an item from a
                                                                         location if all quantities have
                                                                         been transferred.




Revised August 2011                     Prosthetics Basics User Manual                                  21
NPPD Tools Menu (ND)


Menu option           Below are the NPPD Tools Menu (ND) options, the synonym, option name and a
descriptions          description of each.


                           Menu Option           Synonym       Option            Description
                                                                Name
                      Add/Edit HCPCS             AE          RMPR       This option will only edit the
                      Synonyms                               ADD/EDIT   DESCRIPTION and
                                                             HCPCS      SYNONYM in the
                                                             SYNONYM    Prosthetics HCPCS file.
                      DSS HCPCS History          HH          RMPR       This menu will display all
                                                             HCPCS      HCPCS issued on a Patient's
                                                             HISTORY    2319 records for a date range.
                      HCPCS Inquiry              INQ         RMPR       You can look up one HCPCS
                                                             NPPD INQ   at a time with this option.
                      NPPD Detail Display                    RMPR       For users to be able to use the
                                                             NPPD GUI   NPPD Detail Display GUI
                                                                        front-end, this option must be
                                                                        on either their primary or
                                                                        secondary menu options.
                                                                        This option has also been
                                                                        placed on RMPR NPPD
                                                                        TOOLS to give users who
                                                                        have access to the current
                                                                        NPPD options, access to
                                                                        NPPD GUI Detail Display.
                                                                        Note: 'B' type option for use
                                                                        after installation of
                                                                        RMPR*3*71. 'B' type
                                                                        options are not visible to roll
                                                                        & scroll users.
                      Print 2529-3 Single Line   LSL         RMPR       This option will print a single
                                                             NPPDL      line, either New or Repair in
                                                             PRL L      Detail format for the form
                                                                        type 2529-3 only. This is the
                                                                        Lab.

                                                                                 Continued on next page




Revised August 2011                    Prosthetics Basics User Manual                                22
NPPD Tools Menu (ND), Continued


Menu option           Below are the NPPD Tools Menu (ND) options, the synonym, option name and a
descriptions          description of each.


                           Menu Option          Synonym        Option           Description
                                                               Name
                      Print 2529-3 Worksheets LPRT           RMPR      This option provides both
                                                             NPPDL PRT Summary and Detail
                                                                       worksheets. They are
                                                                       divided into the following
                                                                       two basic parts with a station
                                                                       summary of each:

                                                                          * New Activities
                                                                          * Repair Activities

                                                                          The above are further broken
                                                                          down by each mapped NPPD
                                                                          Group with a summary of
                                                                          each. Within each NPPD
                                                                          Group, there is an NPPD
                                                                          Line with a summary. The
                                                                          Detail display adds an
                                                                          itemized listing for each
                                                                          NPPD Line within the NPPD
                                                                          Group, so every transaction
                                                                          for the date range selected is
                                                                          displayed.

                                                                          It is recommended to send
                                                                          this report to a device that
                                                                          will print a 132-right margin.
                                                                          This will not only ensure that
                                                                          you get the entire report, it
                                                                          will also expand the length of
                                                                          some of the data (e.g., Item
                                                                          and HCPCS DESCRIPTION
                                                                          on the Detail Worksheet) to
                                                                          make it more legible.
                      Print NPPD Single Line    SL           RMPR         This option will print a single
                      Detail                                 NPPD         line, either New or Repair in
                                                             PRL L        Detail format.

                                                                                   Continued on next page




Revised August 2011                    Prosthetics Basics User Manual                                  23
NPPD Tools Menu (ND), Continued


Menu option           Below are the NPPD Tools Menu (ND) options, the synonym, option name and a
descriptions          description of each.


                           Menu Option          Synonym        Option             Description
                                                                Name
                      Print NPPD Worksheets     PRT          RMPR        Printing functionality.
                                                             NPPD PRT
                      Print PSAS HCPCS List     MAP          RMPR        Printing functionality.
                                                             NPPD LIST
                      PSAS HCPCS History        PH           RMPR        View history of PSAS
                                                             PSAS        HCPCS.
                                                             HCPCS
                                                             HISTORY
                      Quick Edit 2319 Record    QED2         RMPR        This menu is a quick edit of
                                                             NPPD        the 2319 Record. This will
                                                             QUICK       allow you to select a record
                                                             EDIT        by the number displayed on
                                                                         the detail NPPD report for
                                                                         quick corrections.




Revised August 2011                    Prosthetics Basics User Manual                                   24
                             Section 2: Display/Print Menu
Overview


Introduction          The Display/Print (DD) menu is a sub-menu of Prosthetic Clerks and Official’s
                      master menus. The internal option name is: RMPR DISPLAY/ PRINT, and the
                      synonym is: DD.

                      The audience for this feature is Prosthetics Clerks as well as Officials.


Menu Option           Below is the Prosthetic Official’s Menu.


                         Synonym                           Menu Option
                            PU         Purchasing…
                            DD         Display/Print…
                            UT         Utilities…
                           AM          AMIS…
                            SU         Suspense …
                            CO         Correspondence…
                            SC         Scheduled Meeting and Home/Liaison Visits …
                            PS         Process Form 2529-3…
                            EL         Eligibility Inquiry
                            ET         PSC/Entitlement Records …
                            HO         Home Oxygen Main Menu…
                           INV         Pros Inventory Main …
                            ND         NPPD Tool …


In this section       The following chapters are in this section:


                                                      Topic                                       See Page
                      Display/Print Menu Option Descriptions                                         25
                      Display/Print Patient 2319 (23)                                                26
                      Transaction Inquiry (TI)                                                       42
                      Print All Prosthetic Items (IP)                                                44
                      Print Prosthetics Billings for MAS (BI)                                        46
                      Item History (IH)                                                              49
                      Search for Recalled Item (SE)                                                  51
                      Site Parameter Inquiry (SI)                                                    55




Revised August 2011                      Prosthetics Basics User Manual                                      25
Display/Print Menu Option Descriptions


Menu Option           Below are the Display/Print Menu options with the option name and a description of
descriptions          each.


                                          Display/Print Menu
                          23     Display/Print Patient 2319
                          TI     Transaction Inquiry
                          IP     Print All Prosthetic Items
                          BI     Print Prosthetic Billings for MAS
                          IH     Item History
                          SE     Search for Recall by Lot/Serial Number
                          SI     Site Parameter Inquiry
                          VI     Vendor Inquiry


                      Menu Option        Synonym          Option                   Description
                                                           Name
                  Display/Print             23         RMPR PRINT        Display/print a patient’s VAF 10-
                  Patient 2319                         2319              2319 (Note the 2319 contains
                                                                         more than eligibility)
                  Transaction               TI         RMPR 1358         Inquiry to single purchasing
                  Inquiry                              INQ               transaction.
                  Print All                 IP         RMPR PRINT        This option prints all Prosthetic
                  Prosthetic                           ALL ITEMS         Item Master records along with
                  Items                                                  their new and repair AMIS codes.
                                                                         Lab AMIS codes are not printed
                                                                         with this version of Prosthetics.
                  Print Prosthetic          BI         RMPR PRINT        Prints all NSC (non-service
                  Billings for                         BILL              connected) items issued to
                  MAS                                                    patients for billing purposes.
                  Item History              IH         RMPR ITEM         Prints an item history of all
                                                       HISTORY           purchases made for this item.
                  Search for                SE         RMPR PRINT        Searches the RECORD OF
                  Recalled Item                        RECALL            PROS APPLIANCE/REPAIR
                                                                         file (#660) for recalled item.
                  Site Parameter            SI         RMPR SITE         This menu option should be used
                  Inquiry                              INQ               to review your local site
                                                                         information.
                  Vendor Inquiry            VI         RMPR INQ          This option is an inquiry to the
                                                       VEN               IFCAP VENDOR file (#440).




Revised August 2011                     Prosthetics Basics User Manual                                  26
Display/Print Patient 2319 (23)


Introduction          You can view or print the 10-2319 Prosthetics Veteran patient information from the
                      Display/Print Patient 2319 (23) option. You will be prompted to select a patient.

                      You will also be prompted for a device to print the Patient 10-2319. You have the
                      choice to send the report to a printer by entering a printer at the Device prompt or
                      view selected portions of the 2319 on your terminal screen.

                      Note: Output to a printer will produce a different display than when it is sent to a
                      terminal screen as you have a choice of which eligibility screens to view versus the
                      printout will print the entire Patient 2319.


Options               Here are the screens that you can view from the patient’s 2319:

                      Patient Demographics
                      Clinic Enrollments/Correspondence
                      Entitlement Information
                      Appliance Transactions
                      Auto Adaptive Information
                      Critical Comments
                      Add/Edit Disability Code
                      Home Oxygen Items


In this chapter       The following topics are in this chapter:


                                                    Topic                                       See Page
                      View and Print the Patient 2319                                              27
                      View/Print Patient Demographics                                              29
                      View Clinic Enrollments/Correspondence                                       30
                      View Letters/Correspondence on File                                          31
                      View Entitlement Information                                                 33
                      View Appliance Transactions                                                  34
                      View Auto Adaptive Information                                               36
                      View Critical Comments                                                       37
                      Add/Edit Disability Codes                                                    38
                      View Home Oxygen Items                                                       41




Revised August 2011                      Prosthetics Basics User Manual                                      27
View and Print the Patient 2319


Display the           You can display the 10-2319 Prosthetics Veteran record using the Display/Print
2319                  Patient 2319 (23) Menu option.


Steps                 To display or print the 10-2319 Prosthetics Veteran record, follow these steps:

                        Step                                         Action
                         1       At the Select Display/Print Option prompt, type 23 to
                                 access the Display/Print Patient 2319 (23) option.
                          2      At the Site: prompt, press <Enter> to accept the default setting or type
                                 a “?” to display a list and select a site from the list.
                          3      At the Select Prosthetic Patient prompt, enter a Prosthetic
                                 patient name with the “LAST NAME,FIRST NAME” format.
                          4      Press <Enter> to continue.
                          5      Patient identification information displays. : At the …OK? Yes//
                                 prompt, press <Enter> to continue.


2319 Screen              23       Display/Print Patient 2319
                         TI       Transaction Inquiry
                         IP       Print All Prosthetic Items
                         BI       Print Prosthetic Billings for MAS
                         IH       Item History
                         SE       Search for Recalled Item
                         SI       Site Parameter Inquiry
                         VI       Vendor Inquiry

                      Select Display/Print Option: 23 <Enter> Display/Print Patient 2319
                      SITE: SUPPORT ISC// <Enter>                               499
                      Select PROSTHETIC PATIENT: PROSPATIENT,ONE <Enter> PROSPATIENT,ONE
                      1-1-30    000000001

                                 ...OK? Yes// <Enter>        (Yes)
                                 HINES, IL


                                                                                       Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                     28
View and Print the Patient 2319, Continued


Printing vs.          Printing is different than viewing the 2319 on your terminal! If you elect to print the
Displaying the        2319 information by entering SLAVE or another printer device, the entire Record
2319                  of Appliances and Repairs prints out.


Steps                 To display or print the 10-2319 Prosthetics Veteran record, follow these steps:
(continued)

                        Step                                       Action
                         6       The system displays the Device: Home// prompt. Press <Enter> twice
                                 to display information to your terminal screen or type SLAVE to print
                                 the information to your personal printer.

                                 You can print the information to another printer by typing the printer ID.
                          7      The system displays: Right Margin: 80// (unless you requested
                                 to print to a printer using the SLAVE entry). Press <Enter> to continue.
                          8      The Disability Codes display for the selected patient and you are given a
                                 choice of information to view, edit or print from the patient’s 2319.


2319 Screen           DEVICE: HOME//        <Enter>       TELNET          Right Margin: 80// <Enter>
(continued)
                      *Comments on File.

                      Current Disability Codes are:

                      COS/B               EMPLOYEE             NSC
                      AMP/LAE             SC VIETNAM           S/C

                      Select one of the following
                                1         PATIENT DEMOGRAPHICS
                                2         CLINIC ENROLLMENTS/CORRESPONDENCE
                                3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to
                      continue :




Revised August 2011                      Prosthetics Basics User Manual                                       29
View Patient Demographics


Function              You can view the patient’s demographics by entering 1 at the “Enter 10-2319
description           screen to VIEW...” This includes the patient’s name, social security number, date of
                      birth, address and phone, eligibility and benefits, and claim number, which is shown
                      at the top of the 2319 form.


Steps                 To view patient demographics, follow these steps:

                        Step                                        Action
                         1      Type “1” to select the Patient Demographics screen at the prompt, and
                                press <Enter>.
                          2     The patient demographics display as shown below.
                          3     Press <Enter> to continue. If there is no entry for POW?, you may
                                enter it at this time or press the <Enter> key to accept a default of NO.
                          4     The current Disability Codes display if available.


Patient               Select one of the following:
                                1         PATIENT DEMOGRAPHICS
Demographics                    2         CLINIC ENROLLMENTS/CORRESPONDENCE
Screen                          3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 1
                      <Enter> PATIENT DEMOGRAPHICS
Output
                      PROSPATIENT,ONE               SSN: 000000001   DOB: JAN 1,1930    CLAIM#
                      Phone:                                    Phone:
                      Current Address:                          Primary Next of Kin Address:
                      ABC STREET
                      CHICAGO, ILLINOIS 60000

                      Patient Type: PILL                      Period of Service: OTHER OR NONE
                      Primary Eligibility Code:                  Status: REQUIRED
                      NSC                                        Eligibility Status:

                      Receiving A&A Benefits? NO         Receiving Housebound Benefits? NO
                      Receiving Social Security? NO           Receiving VA Pension? NO
                      Receiving Military Retirement? NO       Receiving VA Disability? NO
                      Prosthetic Disability Code(s): COS/B-NSC AMP/LAE-SC

                      Enter RETURN to continue or '^' to exit:      <Enter>
Disability            *POW? NO
Codes                 Enter return to continue or `^` to exit: <Enter>
                      Current Disability Codes are:
                      COS/B          EMPLOYEE       NSC
                      AMP/LAE        SC VIETNAM     S/C
                      ORTH/PLS       INPATIENT      S/C




Revised August 2011                     Prosthetics Basics User Manual                                      30
View Clinic Enrollments/Correspondence


Function              You can view the clinic enrollments and correspondence for the patient by selecting
description           to view screen 2.


Steps                 To view clinic enrollments and correspondence for a veteran, follow these steps:

                        Step                                     Action
                         1       Type 2 at the prompt: “Enter 10-2319 screen to VIEW (1-8)…” to select
                                 the Clinic Enrollments/Correspondence (2) screen.
                          2      The following information displays: Last Movement Actions, Clinic
                                 Enrollments, and Pending Appointments.
                          3      Press <Enter> at the Would you like to see more
                                 clinics? No// prompt to accept the default setting or Y for Yes.

                                 Note: This prompt may not appear if there aren’t many clinics.
                          4      Press <Enter> to continue.
                          5      To view correspondence, see next page, “View Letters on File.”


Clinic                 Select one of the following:
                                 1         PATIENT DEMOGRAPHICS
Enrollment/                      2         CLINIC ENROLLMENTS/CORRESPONDENCE
Correspondence                   3         ENTITLEMENT INFORMATION
                                 4         APPLIANCE TRANSACTIONS
Screen                           5         AUTO ADAPTIVE INFORMATION
                                 6         CRITICAL COMMENTS
                                 7         ADD/EDIT DISABILITY CODE
                                 8         HOME OXYGEN ITEMS

                       Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 2
                       <Enter>   CLINIC ENROLLMENTS/CORRESPONDENCE

                       PROSPATIENT,TWO            SSN: 000-00-0002        DOB: FEB 28,1949   CLAIM#

                                           Last Movement Actions
                       Trans. Type: DISCHARGE                  Trans. Type: ADMISSION
                       Date: JAN 12,1997@08:00                 Date: JUN 5,1996@12:47:34
                       Type of Movement:                       Type of Movement:
                       REGULAR                                 OPT-SC
                       Ward: 2AS                               Ward: 2AS
                       Physician: PROSPROVIDER,FIVE            Physician: PROSPROVIDER,FIVE
                       Diagnosis: SOB                          Diagnosis: SOB
                                           Clinic Enrollments
                       Clinic                                  Enrollment Date     OPT or AC
                       HOUSE/A                                 MAY 17,1994            OPT
                       TEST1                                   NOV 1,1994@11:10       OPT
                       Would you like to see more clinics? No// n (No) <Enter>

                                           Pending Appointments
                            No Pending Appointments for this Patient
                       Enter RETURN to continue or '^' to exit:    <ENTER>




Revised August 2011                      Prosthetics Basics User Manual                                     31
View Letters/Correspondence on File


Clinic                You can also view the letters on file for the patient using Clinic
Enrollments           Enrollments/Correspondence (2).


Steps                 To view letters on file for a patient, follow these steps:
(continued)

                        Step                                         Action
                         6       The letter listings on file display for a patient if available.
                         7       The Enter a number prompt displays to view a letter. Type the
                                 number of the letter you want to view or print and press <Enter.>
                          8      The DEVICE: HOME// prompt displays. Press <Enter> to continue to
                                 view the letter or enter a printer device. This example shows you how to
                                 view the letter.
                          9      Press <Enter> again after the Right Margin: 80// prompt.


Letters on File       Letters on file:

                      #    Patient        Type of letter   Employee                Date of letter
                      ------------------------------------------------------------------------------
                      1 PROSPATIENT,ONE   ADP FL 10-90     PROSPROVIDER,THREE        DEC 16, 1999
                      2 PROSPATIENT,ONE   HO 30 DAY TEST   PROSPROVIDER,THREE        FEB 08, 2002
                      3 PROSPATIENT,ONE   HO 30 DAY TEST   PROSPROVIDER,THREE        FEB 08, 2002

                      Enter '^' to stop or Enter a number (1-3):1 <Enter>
                      DEVICE: HOME// <Enter>    TELNET    Right Margin: 80//         <Enter>

                                                       REQUEST FOR QUOTATION
                                                         Date: Mar 13, 2000

                           TO: VENDOR NAME                                   FROM: PROSVENDOR,ONE
                               7000 SOUTH ST                                          SUPPORT ISC
                               CHICAGO, ILLINOIS      60620
                                                                                     CHICAGO, IL     60619

                               Vendor Phone #: (555)
                      Veteran: PROSPATIENT,ONE
                                                                                   SSN:      000000001

                           Your firm is being considered for the following:
                             PROSTHETIC LEG

                           An estimate on the above-listed item(s) is requested. YOUR QUOTATION
                           DOES NOT CONSTITUTE A PURCHASE ORDER. Upon completion of the esti-
                           mate, return the original to the Veterans Affairs facility indicated
                           above and retain a copy for your files.

                           If approved, a purchase order will be prepared and forwarded to you.

                           Sincerely,

                           PROSPROVIDER,SIX, ACTING CHIEF, PROSTHETICS SERVICE CHIEF


                                                                                           Continued on next page



Revised August 2011                       Prosthetics Basics User Manual                                      32
View Letters/Correspondence on File, Continued


Output                A letter on file sample is shown below for a patient’s Vendor Estimate.


Steps                 To view letters on file, continue to follow these steps:
(continued)

                        Step                                         Action
                         10      The letter(s) displays if available for a patient.
                         11      At the Would you like to see more letters? No//
                                 prompt, press <Enter> to accept the default of No. If you want to view
                                 more letters that are on file, type Y for Yes.
                         12      At the Do You wish to create a correspondence
                                 letter? No// prompt, press <Enter> to accept the default setting
                                 or type Y for Yes. (See the Correspondence section for instructions.)
                         13      The Suspense Menu may display for you to enter a request for a
                                 Prosthetic item or service (depending on the settings at your site).


Sample Letter                                        VENDOR'S ESTIMATE
                                                (To be completed by Vendor)
Screen                     ----------------------------------------------------------------------
                           |      Article or Service       |Quantity| Unit |Unit Cost|Total Cost|
                           ----------------------------------------------------------------------
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           |                               |        |      |         |          |
                           ----------------------------------------------------------------------
                           | Vendor:                            Contract number (if applicable) |
                           | Address:                                                           |
                           | City:                                                              |
                           | State:             Zip:                                            |
                           | Telephone:                                                         |
                           | Date:                         Signature & Title of Company Official|
                           | Note:List Terms/Discounts if Applicable                            |
                           ----------------------------------------------------------------------
                                                                                 FL 10-90 ADP
                      Enter RETURN to continue or '^' to exit:

                      Would you like to see more letters? No// <ENTER>
                      Do you wish to create a correspondence letter? No//        <ENTER>




Revised August 2011                      Prosthetics Basics User Manual                                   33
View Entitlement Information


Function              You can view the patient’s entitlement information by typing (3) at the “Enter 10-
description           2319 screen to VIEW...” prompt.


Steps                 To view entitlement information, follow these steps:

                        Step                                      Action
                         1       Select the Entitlement Information screen by typing 3.
                         2       The patient name, social security number, date of birth, and claim
                                 number displays as well as any entitlements. This includes a clothing
                                 allowance if applicable, automobile information, and items returned.


Entitlement           Select one of the following:
                                1         PATIENT DEMOGRAPHICS
Screen                          2         CLINIC ENROLLMENTS/CORRESPONDENCE
                                3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 3
                      <Enter> ENTITLEMENT INFORMATION

                      PROSPATIENT,ONE               SSN: 000-00-0001       DOB: JAN 1,1930   CLAIM#

                      PSC Issue Card:   Appliance     Ht 68   Wt 192     Eyes BR   Hair GY   Serial
                      Number
                      JAN 31, 2000      TEST ITEM

                      Clothing Allowance:   Date: 04-01-01 ELIGIBLE STATIC
                                            Date of Exam: JUL 11, 2000
                      Examiner: PROSPROVIDER,EIGHT

                                             Desc:
                                             Date: 03-15-02 NOT-ELIGIBLE NON-STATIC
                                             Date of Exam: MAR 10, 2002 Examiner: PROSPROVIDER,NINE
                                             Desc:
                                             Date: 05-08-02 ELIGIBLE STATIC
                                             Date of Exam: MAY 08, 2002 Examiner: PROSPROVIDER,SEVEN
                                             Desc: TESTING


                      Items Returned: Date           Item                           Serial     Status

                      Enter RETURN to continue or '^' to exit:




Revised August 2011                     Prosthetics Basics User Manual                                     34
View Appliance Transactions


Function              You can view appliance transactions for the patient by typing 4 at the “Enter 10-
description           2319 screen to VIEW...” prompt.


Steps                 To view entitlement information, follow these steps:

                           Step                                     Action
                            1       Select the Appliance Transactions screen by typing 4.
                            2       If you want to view the complete entry for a transaction, type the number
                                    of the transaction at the “Enter 1-n to show full entry...”
                                    prompt.


Appliance             Select one of the following:
                                1         PATIENT DEMOGRAPHICS
Transactions                    2         CLINIC ENROLLMENTS/CORRESPONDENCE
Screen                          3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to
                      continue : 4 <Enter> APPLIANCE TRANSACTIONS

                      PROSPATIENT,TWO                 SSN: 000-00-0002          DOB: FEB 28,1949           CLAIM#

                             Date      Qty   Item       Type    Vendor        Sta    Serial   Delivery Date Tot
                      Cost
                      1.   02/16/00 1        TEST ITEM     I   VENDOR,TWO           499                       9.00
                      2.   02/16/00 2        TEST ITEM     I   VENDOR,TWO           499                       5.00
                      3.   02/16/00 1        EYEGLASSES    I   VENDOR,TWO           499                       0.00
                      4.   05/07/03 1        WHEELCHAIR    I   VENDOR,THREE                     05/07/03    300.00
                      +=Turned-In      *=Historical Data       I=Initial   X=Repair       S=Spare   R=Replacement

                      Enter 1-19 to show full entry, '^' to exit or `return` to continue.
                      4 <Enter>


                                                                                                Continued on next page




Revised August 2011                          Prosthetics Basics User Manual                                         35
View Appliance Transactions, Continued


Continued…            Below is the complete entry for the transaction selected previously.


Appliance/            PROSPATIENT,ONE                SSN: 000-00-0001   SUPPORT ISC          DOB: 01-01-1930
                                            APPLIANCE/REPAIR LINE ITEM DETAIL                       <4-14>
Repair Line
Item Detail           TYPE OF FORM: STOCK ISSUEINITIATOR: PROSPROVIDER,THREE     DATE: MAY 07, 2003
                      DELIVER TO:
                      TYPE TRANS: INITIAL ISSUE      QTY: 1    SOURCE: COMMERCIAL
                      VENDOR:        PROSVENDOR,THREE
                      VENDOR PHONE: (800) 255-5162
                                     CORPORATE ORDER ENTRY
                                     ANY PARK,    ILLINOIS     60064
                      DELIVERY DATE: MAY 07, 2003
                      TOTAL COST: $300.00            OBL:
                      REMARKS:
                      DISABILITY SERVED: SC/IP
                      APPLIANCE: WHEELCHAIR - MANUAL
                      PSAS HCPCS: K0005     ULTRALIGHTWEIGHT WHEELCHAIR
                      ICD-9 Code:
                      CPT MODIFIER: NU
                      DESCRIPTION: ULTRALIGHTWEIGHT WHEELCHAIR
                      EXTENDED DESCRIPTION:

                      ULTRALIGHTWEIGHT WHEELCHAIR

                      Enter RETURN to continue or '^' to exit:




Screen output         Below is the continued screen output from the Appliance Transaction information.




Revised August 2011                      Prosthetics Basics User Manual                                    36
View Auto Adaptive Information


Function              You can view the patient’s auto adaptive information by typing 5 at the “Enter 10-
description           2319 screen to VIEW...” prompt.


Auto Adaptive         Select one of the following:
                                1         PATIENT DEMOGRAPHICS
Screen                          2         CLINIC ENROLLMENTS/CORRESPONDENCE
                                3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 5
                      AUTO ADAPTIVE INFORMATION

                      NAME: PTROSPATIENT,TWO         SSN: 000000002 CLAIM NO.
                      VEHICLE ID#         YEAR PURCHASE DATE MAKE      MODEL         PAGE 1
                      PROCESS DATE   ITEM              QTY        COST       AMIS      TYPE
                                                    '*' Denotes Inactive Vehicle of Record
                      ---------------------------------------------------------------------
                      VAN-123             199 MAR 13, 2000    FORD       VAN      4502: MAR 13, 2000

                      MAR 13, 2000    AIR-CONDITIONING   1        $500.00   ADAP EQP   INITIAL
                      MAR 13, 2000    CB RADIO           1        $100.00   VAN MOD    INITIAL

                                                       Total/Date:          $600.00

                      Enter RETURN to continue or '^' to exit:




Revised August 2011                     Prosthetics Basics User Manual                                     37
View Critical Comments


Function              You can view, add, or edit any critical comments for the patient by typing 6 at the
description           “Enter 10-2319 screen to VIEW...” prompt.


Steps                 To add or edit critical comments, follow these steps:

                        Step                                      Action
                         1       Select the Critical Comments option by typing 6.
                         2       At the Would you like to Add/Edit Patient Critical Comments? No//
                                 prompt, type Y for Yes, and press <Enter>.
                          3      At the Edit? No// prompt, type Y for Yes, and press <Enter>.
                          4      The word processing text editor displays for you to type your note.
                          5      Press the Num Lock key and the E key together to exit and save the
                                 information.


Critical              Select one of the following:
                                1         PATIENT DEMOGRAPHICS
Comments                        2         CLINIC ENROLLMENTS/CORRESPONDENCE
Screen                          3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 6
                      CRITICAL COMMENTS

                      PATIENT:PROSPATIENT,ONE                                CRITICAL COMMENTS
                      No Patient Critical Comments Recorded for this patient!

                      Would you like to Add/Edit Patient Critical Comments? No// Y        (Yes)
                      CRITICAL COMMENTS:
                        No existing text
                        Edit? NO// YES

                      ==[ WRAP ]==[ INSERT ]======< CRITICAL COMMENTS >=====[ <PF1>H=Help]=
                      Editing Critical Comments.




                      <======T======T======T======T======T======T======T======T======T>====

                      PATIENT: PROSPATIENT,ONE                                    CRITICAL COMMENTS
                      Editing Critical Comments.

                      Would you like to Add/Edit Patient Critical Comments? No// <Enter> (No)
                      *Comments on file




Revised August 2011                      Prosthetics Basics User Manual                                     38
Add/Edit Disability Codes


Function              You can add to or edit the patient’s disability codes by typing 7 at the “Enter 10-
description           2319 screen to VIEW...” prompt.


Steps                 To add or edit a Disability Code, follow these steps:

                        Step                                        Action
                         1        Select the Add/Edit Disability Code option by typing 7.
                         2        At the Would you like to Add/Edit a Disability Code to the Patient’s
                                  2319? Yes// prompt, press <Enter.>
                          3       At the Select Prosthetic Disability Code prompt, type
                                  a Disability Code, and press <Enter.> (You can also type two question
                                  marks to view a list and select one.)

Add/Edit              Select one of the following:
                                1         PATIENT DEMOGRAPHICS
Disability Code                 2         CLINIC ENROLLMENTS/CORRESPONDENCE
Screen                          3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 7
                      <Enter> ADD/EDIT DISABILITY CODE
                      Would you like to ADD/EDIT a Disability Code to the Patient's 2319? YES//
                      <Enter>

                      Select PROSTHETIC DISABILITY CODE: ??      <Enter>
                      Choose from:
                         AMP/LAE     SC    SC VIETNAM
                         COS/B       NSC   EMPLOYEE

                              You may enter a new PROSTHETIC DISABILITY CODE, if you wish
                              This is a pointer to the Prosthetic Disability Code file (662).

                         Choose from:
                         1            AMP/LAE
                         2            AMP/LAK
                         3            AMP/LBE

                      Select PROSTHETIC DISABILITY CODE: 1 <Enter> AMP/LAE
                               ...OK? Yes// <Enter>   (Yes)
                                     SC    SC VIETNAM

                      Select one of the following:
                                   E          EDIT DISABILITY CODE
                                   A          ADD DUPLICATE DISABILITY CODE

                      Enter response: EDIT// A <Enter> ADD DUPLICATE DISABILITY CODE
                      PROSTHETIC DISABILITY CODE: AMP/LAE// <Enter>


                                                                                        Continued on next page



Revised August 2011                      Prosthetics Basics User Manual                                     39
Add/Edit Disability Codes, Continued


Add a Code            To continue to add a Disability Code, see the sample screen below. At the Would
                      you like to Mark a Disability Code as Deleted? NO// prompt, press <Enter> to
                      accept the default setting.


Steps                 To add or edit a Disability Code, follow these steps:

                        Step                                      Action
                         1        Select the Add/Edit Disability Code option by typing 7.


Add/Edit              SERVICE/NON-SERVICE: ??
                           Enter `1` for Service Connected or `2` for Non-Service Connected.
Disability Code            Choose from:
Screen                       1        SERVICE CONNECTED
                             2        NON-SERVICE CONNECTED
(continued)           SERVICE/NON-SERVICE: 2 NON-SERVICE CONNECTED

                      ELIGIBILITY CATEGORY: ??
                              This field stores the Eligibility Category for the Patient.

                           Choose from:
                             1        SC VIETNAM
                             2        ALL OTHER SERVICE-CONNECTED
                             3        NSC A&A
                             4        OTHERS ELIGIBLE
                             5        V.I.S.T.
                             6        VOC REHAB
                             7        PHC
                             8        INPATIENT
                             9        EMPLOYEE
                             10       PRIMA FACIA
                      ELIGIBILITY CATEGORY: 1 SC VIETNAM

                      Select PROSTHETIC DISABILITY CODE:        <Enter>

                      PROSPATIENT,ONE HAS THE FOLLOWING DISABILITY CODES:

                           COS/B       NSC     EMPLOYEE
                           AMP/LAE     SC      SC VIETNAM
                           AMP/LAE     NSC     SC VIETNAM

                      Would you like to Mark a Disability Code as Deleted? NO// <Enter>
                      *Comments   on file


                                                                                      Continued on next page




Revised August 2011                         Prosthetics Basics User Manual                               40
Add/Edit Disability Codes, Continued


To Edit a Code        You can edit and delete a Disability Code using this screen. To edit a disability
                      code, type E for Edit Disability Code at the Enter Response prompt. Press <Enter>
                      at the additional prompts to accept the default settings.

                      You delete a Disability Code for a patient by entering YES at the Would you like to
                      Mark a Disability Code as Deleted? No// prompt.


Add/Edit              Select one of the following:
Disability Code                 E           EDIT DISABILITY CODE
Screen                          A           ADD DUPLICATE DISABILITY CODE

                      Enter response: EDIT// <Enter> DISABILITY CODE
                      PROSTHETIC DISABILITY CODE: AO/AUTO// <Enter>
                      SERVICE/NON-SERVICE: SERVICE CONNECTED// <Enter>
                      ELIGIBILITY CATEGORY: SC VIETNAM// <Enter>

                      Select PROSTHETIC DISABILITY CODE: <Enter>
                      PROSPATIENT,ONE HAS THE FOLLOWING DISABILITY CODES:

                           COS/B      NSC   EMPLOYEE
                           AMP/LAE    SC    SC VIETNAM
                           AMP/LAE    NSC   SC VIETNAM
                           ORTH/PLS   SC    INPATIENT
                           ORTH/DLF   SC    SC VIETNAM
                           AO/AUTO    SC    SC VIETNAM


                      Would you like to Mark a Disability Code as Deleted? NO// <Enter>
                      *Comments on file




Revised August 2011                     Prosthetics Basics User Manual                                  41
View Home Oxygen Items


Function              You can view the patient’s home oxygen information by typing 8 at the “Enter 10-
description           2319....” prompt.


Sample output         Select one of the following:
                                1         PATIENT DEMOGRAPHICS
                                2         CLINIC ENROLLMENTS/CORRESPONDENCE
                                3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue: 8
                      <Enter> HOME OXYGEN ITEMS
                      PROSPATIENT,THREE     000-00-0003
                      Current Prescription (#5)
                            Active Date: OCT 16,2003    Expiration Date: OCT 15,2004
                        CONCENTRATOR 02 @ 28% VIA COOL AEROSOL TRACH MASK, BUNN COMPRESSOR, M TANK

                            10 E TANKS, 4 TRACH MASKS, 6 1000 ML PREFILLED AND 4 500 ML AEROSOL BTLS
                            PER MO.
                            NEBULIZER .5 CC ALBUTEROL & 2.5 CC IPRATROPRIUM,
                            2 #6 SHILEY TRACH TUBES CUFFED, UNFENESTRATED EVERY 6 MONTHS WITH NON-
                            DISPOSABLE INNER CANNULAS
                      Enter RETURN to continue or '^' to exit: <Enter>

                      PROSPATIENT,THREE     SSN: 000-00-0003      DOB: OCT 12,1954  CLAIM# 391580866
                        Date    Qty    Item     Type Vendor         Sta Serial Delivery Date Tot Cost
                      1. 01/27/04 4    HUMIDIFIER    X FIRST    COMM 695           02/11/04      26.60
                         4111
                      2. 01/27/04 1    OXYGEN-REN    X FIRST    COMM     695       02/11/04       90.25
                         4111
                      3. 01/27/04 1    OX-COMPRES    X FIRST    COMM     695       02/11/04       42.75
                         4111
                      4. 12/17/03 12 NEBULIZER      I FIRST     COMM     695       12/22/03       14.76
                         4111
                      5. 12/17/03 1    OXYGEN-REN    X FIRST    COMM     695       12/22/03       90.25
                         4111
                      6. 12/17/03 8    OXYGEN-REF    X FIRST    COMM     695       12/22/03       72.24
                         4111
                      7. 12/17/03 1    OX-COMPRES    X FIRST    COMM     695       12/22/03       42.75
                         4111
                      8. 11/24/03 4    HUMIDIFIER    X FIRST    COMM     695       12/05/03       26.60
                         4111
                      9. 11/24/03 4    NEBULIZER    I FIRST     COMM     695       12/05/03        4.92
                         4111
                      10. 11/24/03 1   OXYGEN-REN    X FIRST    COMM     695       12/05/03       90.25




Revised August 2011                     Prosthetics Basics User Manual                                   42
                                   Transaction Inquiry (TI)
View a Transaction


Function              You can view a single purchasing transaction through the Transaction Inquiry (TI)
description           option from the Display/Print Menu. (This option displays purchasing information
                      for a specific transaction from the Prosthetics 1358 file (#664.))


Steps                 To perform a transaction inquiry, follow these steps:

                        Step                                      Action
                         1       Type TI for the Transaction Inquiry option from the Display/Print
                                 Menu.
                          2      At the Select Patient Name or Transaction Number
                                 prompt, type a patient name or transaction number, and press <Enter>.
                          3      Select the transaction you want to view from the list of transactions
                                 displayed.


Transaction              23       Display/Print Patient 2319
                         TI       Transaction Inquiry
Inquiry Screen           IP       Print All Prosthetic Items
                         BI       Print Prosthetic Billings for MAS
                         IH       Item History
                         SE       Search for Recalled Item
                         SI       Site Parameter Inquiry
                         VI       Vendor Inquiry

                      Select Display/Print Option: TI <Enter> Transaction Inquiry

                      Select Patient Name or Transaction Number: PROVIDER1,TWO <Enter>
                      PROSPATIENT,ONE        1-1-30
                         453890765     NO     PILL             HINES, IL
                      1 PATIENT,ONE 1-31-2000 PATIENT,ONEClosed REF: 0002 EYEGLASSES
                      2 PATIENT,ONE 1-31-2000 PATIENT,ONEClosed REF: 0003 TEST ITEM
                      3 PATIENT,ONE 1-31-2000 PATIENT,ONE        REF: 0004 TEST ITEM
                      4 PATIENT,ONE 1-31-2000 PATIENT,ONE                   TEST ITEM
                      5 PATIENT,ONE 1-31-2000 PATIENT,ONE        REF: 0003 PICKUP/DELIVERY

                      Press <RETURN> to see more, '^' to exit this list, OR CHOOSE 1-5: 1
                      <Enter>



                                                                                     Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                  43
View a Transaction, Continued


Print a               You can also print a transaction as well as view one.
transaction


Steps                 To perform a transaction inquiry, follow these steps:
(continued)

                        Step                                       Action
                         4       The Device prompt appears.
                         5       At the Device prompt, press <Enter> twice to display information to
                                 your terminal screen. (You can also type SLAVE to send the
                                 information to your printer, and press <Enter>.)
                          6      The transaction information displays for the requested patient.


Transaction           1-31-2000 PROSPATIENT,ONE             Closed          REF: 0002    EYEGLASSES
Inquiry Screen        DEVICE: <Enter> TELNET     Right Margin: 80// <Enter>
                      PROSTHETICS 1358 LIST                    SEP 27,2000 09:46     PAGE 1
                      ---------------------------------------------------------------------

                      DATE: JAN 31, 2000                                  PATIENT: PROSPATIENT,ONE
                        OBLIGATION NUMBER: 499-C45004                     VENDOR: VENDOR PRODUCTION
                        C.P.: 499-94-2-055-0047                           REFERENCE: 499-C45004-0002
                        CLOSE OUT DATE: JAN 31, 2000@13:05:53             INITIATOR: PROVIDER,THREE
                        EST. SHIPPING CHARGE: 1                           SHIPPING ENTRY: JAN 31, 2000
                        STATION NAME: SUPPORT ISC
                      ITEM: EYEGLASSES                                    BRIEF DESCRIPTION: ITEM 1
                        UNIT COST: 1                                      QTY: 1
                        UNIT OF ISSUE: EA                                 TYPE OF TRANSACTION: INITIAL
                      ISSUE
                        PATIENT CATEGORY: SC/OP                           SOURCE: COMMERCIAL
                        APPLIANCE/REPAIR: JAN 31, 2000                    PSAS HCPCS: A4500
                        CLOSE-OUT REMARKS: CLOSE                          FORM TYPE: 2421
                        CLOSED BY: PROVIDER,THREE                           DELIVER TO: VETERAN
                        DATE REQUIRED: MAR 01, 2000                       DELIVERY TIME: 30

                      Select Patient Name or Transaction Number: <Enter> to exit the
                      screen.




Revised August 2011                      Prosthetics Basics User Manual                                  44
                               Print All Prosthetic Items (IP)
Overview


Introduction          The Print All Prosthetic Items (IP) option prints all Prosthetic Item Master records
                      along with their new and repair AMIS codes. This listing is useful for Purchasing
                      Agents as a catalog of all current Prosthetic items available for issue, and for
                      Prosthetics Supervisors to validate correctness of Prosthetics AMIS codes.

                      Note: Lab AMIS codes are not printed with this version of Prosthetics.


Steps                 To print all Prosthetic items, follow these steps:

                        Step                                       Action
                         1       Type IP for the Print All Prosthetic Items option from the Display/Print
                                 Menu.
                          2      At the Device prompt, press <Enter>. The following displays:
                                 Right Margin: 80//.
                          3      Press <Enter>.


Print All                23       Display/Print Patient 2319
                         TI       Transaction Inquiry
Prosthetic               IP       Print All Prosthetic Items
Items Screen             BI       Print Prosthetic Billings for MAS
                         IH       Item History
                         SE       Search for Recalled Item
                         SI       Site Parameter Inquiry
                         VI       Vendor Inquiry

                      Select Display/Print Option: IP <Enter> Print All Prosthetic Items
                      DEVICE: <Enter>    TELNET    Right Margin: 80// <Enter>




Recommendation        It is recommended that you run this option quarterly to verify the AMIS codes that
                      have been assigned. This will assure that you will receive proper calculations in
                      your AMIS Worksheets.




Revised August 2011                       Prosthetics Basics User Manual                                    45
View the Prosthetic Item Master List


Prosthetic Item       You can view the Prosthetic Item Master List from the Print All Prosthetic Items
Master List           (IP) option. Notice that the Item Master List below has three pages displayed with
                      the Item Number, short description, and extended description.


Print All             PROS ITEM MASTER LIST                              SEP 27,2000   09:47    PAGE 1

Prosthetic            ITEM
Items Screen          NUMBER SHORT DESCRIPTION           DESCRIPTION
                      ------------------------------------------------------------------------------
(continued)           3       **SYRINGE-SUBCUTANEOUS-3I 3 IN SUBCUTANEOUS SYRINGE (3)
                              ANC:   05 A     ARC: R01    ONC: 10 ORC: R15 A RNC:         RRC:
                              ANC:   01 A     ARC: R15    ONC:      ORC:        RNC:      RRC:
                              ANC:   04 A     ARC: R03 B ONC: 03 ORC: R15 A RNC:          RRC:
                      59      EYEGLASSES                 EYEGLASSES
                              ANC:   11       ARC: R06    ONC: 10 ORC: R15 A RNC: 04 RRC:        R13
                      10000   EYEGLASSES                 EYEGLASSES
                              ANC:   11       ARC: R06    ONC:      ORC:        RNC:      RRC:

                      PROS ITEM MASTER LIST                              SEP 27,2000   09:47    PAGE 2

                      ITEM
                      NUMBER SHORT DESCRIPTION           DESCRIPTION
                      ------------------------------------------------------------------------------

                              ANC:   04 A     ARC:          ONC:     ORC:         RNC:      RRC:
                      903     TEST ITEM                    TEST
                              ANC:   05 D     ARC: R15      ONC:     ORC: R15 B RNC:        RRC:
                      55      WHEELCHAIR-ADULT/HEMI/BLU    STANDARD ADULT ROLLS 2000 HEMI WHEELCHAIR
                                                           WITH ELEVATING LEG REST AND ANTI TIPPER,
                                                           BLUE (55)
                              ANC:   R14      ARC: R15      ONC: 10 ORC: R15 A RNC: 10 RRC:        R12
                      56      WHEELCHAIR-CLASSIC-18X16     PREMIER CLASSIC STANDARD WIDTH AND DEPTH,
                                                           18X16, SEAT HEIGHT (19 3/4) BACK HEIGHT
                                                           STYLE 16 1/2IN, FIXED DETACHABLE DESK
                                                           LENGTH ARMS, REAR WHEEL SIZE 24X11IN,
                                                           BLACK MOLDED WITH SOLID SNAP ON TIRES,
                                                           CHROME PLATED STEEL HANDRIMS, PUSH TO LOCK
                                                           WHEEL LOCKS, 8X1 CASTERS, BLACK MOLDED

                      PROS ITEM MASTER LIST                              SEP 27,2000   09:47    PAGE 3

                      ITEM
                      NUMBER SHORT DESCRIPTION           DESCRIPTION
                      ------------------------------------------------------------------------------
                                                         WITH SOLID TIRES, REGAL BLUE LEATHERETTE
                                                         UPHOLSTERY, CHROME FRAME FINISH (56)
                              ANC:   17 A     ARC: R15    ONC: 12 ORC: R15 D RNC: 09 RRC:




Revised August 2011                     Prosthetics Basics User Manual                                     46
                       Print Prosthetic Billings for MAS (BI)
Overview


Introduction          The Print Prosthetic Billings for MAS (BI) option prints all NSC (non-service
                      connected) items issued to patients for billing purposes. MAS stands for Medical
                      Administrative Services.


Steps                 To view Prosthetic Billings for MAS, follow these steps:

                        Step                                       Action
                         1       Type BI for the Print Prosthetic Billings for MAS option from the
                                 Display/Print Menu.
                          2      At the Site prompt, enter the name of the site and press <Enter>.
                          3      At the Start With Delivery Date prompt, enter the beginning
                                 date of the date range. (For instance if the report should cover one year
                                 from the current date, enter T-365 which stands for “Today minus 365
                                 days from today”).
                          4      At the End With Delivery Date prompt, type a T for Today if
                                 you wan to enter the end of the date range with the current date.
                          5      At the Device prompt, enter a printer or press <Enter>. The following
                                 displays: Right Margin: 80//. Press <Enter> again.


Print Prosthetic         23     Display/Print Patient 2319
                         TI     Transaction Inquiry
Billings for             IP     Print All Prosthetic Items
MAS Screen               BI     Print Prosthetic Billings for MAS
                         IH     Item History
                         SE     Search for Recalled Item
                         SI     Site Parameter Inquiry
                         VI     Vendor Inquiry

                      Select Display/Print Option: BI Print Prosthetic Billings for MAS
                      SITE: Hines Development System//  499

                      Start With Delivery Date: T-365 (SEP 28, 1999)
                      End With Delivery Date: T (SEP 27, 2000)
                      DEVICE: HOME// <Enter> TELNET    Right Margin: 80// <Enter>

                      ...EXCUSE ME, JUST A MOMENT PLEASE...
                      ...PREPARING TO PRINT PROSTHETIC BILLING...



Purchasing            Each transaction done through the Purchasing Menu requires the Prosthetic
Menu                  Purchasing Agent to enter the correct patient category for each item issued. Any
                      item issued to a veteran who is NSC/OP and has insurance recorded in the MAS
                      Patient file, will appear on this listing for billing purposes in MAS.




Revised August 2011                     Prosthetics Basics User Manual                                       47
View Prosthetic Billing Information


Billing               Below are the first two pages of the Prosthetic billing information for this sample.
Information


Print Prosthetic      PATIENT NAME     SSN         SEP 28, 1999-SEP 27, 2000STA 499 PAGE 1
                      ------------------------------------------------------------------------------
Billings for          TEST,A                5465
MAS Screen               Insurance   COB Subscriber ID     Group       Holder Effective Expires
                         ===========================================================================
(continued)              BLUE CROSS      9432              111         SELF    03/01/70


                      06/21/00 06/21/00    TEST ITEM                           QTY: 1 TOTAL COST:       1.00

                      PROSPATIENT,TWO        0002
                         Insurance    COB Subscriber ID    Group       Holder Effective Expires
                         ===========================================================================
                         AETNA            72727272         1633        SELF    01/01/90   01/01/99
                         BLUE CROSS    p 088888888         3333        SELF    01/01/93


                      12/13/99 12/20/99* EYEGLASSES                            QTY: 1 TOTAL COST:      50.00


                           PATIENT NAME     SSN             SEP 28, 1999-SEP 27, 2000STA 499 PAGE 2
                      ------------------------------------------------------------------------------

                      PROSPATIENT,TWO       0002
                         Insurance   COB Subscriber ID     Group       Holder Effective Expires
                         ===========================================================================
                         AETNA           72727272          1633        SELF    01/01/90   01/01/99
                         BLUE CROSS   p 088888888          3333        SELF    01/01/93


                      12/13/99 12/13/99    EYEGLASSES                          QTY: 1 TOTAL COST:       5.00
                      12/13/99 12/13/99    WHEELCHAIR-ADULT/HEMI/BLUE-STD      QTY: 1 TOTAL COST:       5.00

                      Enter RETURN to continue or '^' to exit: <Enter>


                                                                                        Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                     48
View Prosthetic Billing Information, Continued


Billing               Below are pages 3 and 4 of the Prosthetic billing information of this report.
information


Print Prosthetic           PATIENT NAME     SSN             SEP 28, 1999-SEP 27, 2000STA 499 PAGE 3
                      ------------------------------------------------------------------------------
Billings for
MAS Screen            PROSPATIENT,TWO       0002
                         Insurance   COB Subscriber ID     Group       Holder Effective Expires
(continued)              ===========================================================================
                         AETNA           72727272          1633        SELF    01/01/90   01/01/99
                         BLUE CROSS   p 088888888          3333        SELF    01/01/93


                      12/13/99   12/13/99    EYEGLASSES                       QTY:   1   TOTAL   COST:   50.00
                      12/13/99   12/13/99    EYEGLASSES                       QTY:   1   TOTAL   COST:   50.00
                      12/13/99   12/13/99    EYEGLASSES                       QTY:   1   TOTAL   COST:   50.00
                      12/13/99   12/13/99    EYEGLASSES                       QTY:   1   TOTAL   COST:   50.00
                      12/13/99   12/13/99    EYEGLASSES                       QTY:   1   TOTAL   COST:    5.00
                      12/13/99   12/13/99    WHEELCHAIR-ADULT/HEMI/BLUE-STD   QTY:   1   TOTAL   COST:    5.00
                      12/20/99   12/20/99    EYEGLASSES                       QTY:   1   TOTAL   COST:   50.00

                      Enter RETURN to continue or '^' to exit: <Enter>

                           PATIENT NAME     SSN             SEP 28, 1999-SEP 27, 2000STA 499 PAGE 4
                      ------------------------------------------------------------------------------

                      PROSPATIENT,TWO       0002
                         Insurance   COB Subscriber ID     Group       Holder Effective Expires
                         ===========================================================================
                         AETNA           72727272          1633        SELF    01/01/90   01/01/99
                         BLUE CROSS   p 088888888          3333        SELF    01/01/93


                      12/20/99   12/20/99    EYEGLASSES                       QTY:   1   TOTAL   COST:    5.00
                      12/20/99   12/20/99    WHEELCHAIR-ADULT/HEMI/BLUE-STD   QTY:   1   TOTAL   COST:    5.00
                      12/20/99   12/20/99    EYEGLASSES                       QTY:   1   TOTAL   COST:   50.00
                      12/20/99   12/20/99    EYEGLASSES                       QTY:   1   TOTAL   COST:    5.00
                      12/20/99   12/20/99    WHEELCHAIR-ADULT/HEMI/BLUE-ST    QTY:   1   TOTAL   COST:    5.00
                      01/07/00   01/07/00    EYEGLASSES                       QTY:   1   TOTAL   COST:    5.00
                      01/07/00   01/07/00    EYEGLASSES                       QTY:   1   TOTAL   COST:    5.00




Revised August 2011                         Prosthetics Basics User Manual                                   49
                                         Item History (IH)
View Item History


Introduction          The Item History (IH) option from the Display/Print Menu prints the history of all
                      purchases made for an item you select. It allows you to review the history of all
                      items issued during any date range you may choose. You can view the request date,
                      patient name, SSN, Vendor, Serial Number, quantity, total cost, and Initiator.

                      There are four types of transactions including: 1) Initial Issue, 2) Replacement,
                      3) Repair, and 4) Spare. You can select multiple items to view at one time. This
                      includes who received the item, cost of the item, quantity, purchased or issued, etc.


Steps                 To view item history, follow these steps:

                        Step                                      Action
                         1       Type IH for the Item History option from the Display/Print Menu.
                         2       At the Site prompt, press <Enter> to accept the default Site or type
                                 two question marks to display and list and select a different site.
                          3      Once you have selected a site, an OK? Yes// prompt displays.
                          4      Press <Enter> and another Select Item prompt displays.


Item History             23      Display/Print Patient 2319
                         TI      Transaction Inquiry
Screen                   IP      Print All Prosthetic Items
                         BI      Print Prosthetic Billings for MAS
                         IH      Item History
                         SE      Search for Recalled Item
                         SI      Site Parameter Inquiry
                         VI      Vendor Inquiry

                      Select Display/Print Option: IH <Enter> Item History
                      SITE: Hines Development System2//   ST. NUM. 578

                      Select ITEM 1: ?? <Enter>
                         Choose from:
                         3            **** THIS ITEM IS INACTIVE ****
                         7
                         9            **** THIS ITEM IS INACTIVE, USE ITEM NUMBER 11 ****
                         40
                         55

                      Select ITEM 1: 3
                           1   3       **** THIS ITEM IS INACTIVE ****
                           2   345-1234 55
                      CHOOSE 1-2: 2 <Enter> 55
                               ...OK? Yes//   (Yes) <Enter>

                      Select ITEM 2: <Enter> or enter another item.




Revised August 2011                      Prosthetics Basics User Manual                                       50
View Item History Within a Date Range


Item Master           Please note that the item number and the item name must correspond with what is
file                  contained in the Prosthetics Item Master file when you are requesting to view items
                      in the Item History option.


Steps                 To view item history, follow these steps:
(continued)

                        Step                                       Action
                         5       At the Beginning Date: T-30// prompt, press <Enter> to
                                 accept this default setting. You can also enter a different entry for a
                                 beginning date.
                          6      At the Ending Date: TODAY// prompt, press <Enter> to accept
                                 this default setting. You can also enter a different entry for an ending
                                 date.
                          7      At the Device prompt, press <Enter>. The following displays:
                                 Right Margin: 80//. Press <Enter> again.
                          8      The Item History displays.


Item History          Beginning Date: T-30// <Enter> (AUG 29, 2000)
                      Ending Date: TODAY// <Enter>    (SEP 28, 2000)
Screen                DEVICE: HOME// <Enter>   TELNET    Right Margin: 80// <Enter>
(continued)
                      ...EXCUSE ME, LET ME THINK ABOUT THAT A MOMENT...
                      ITEM HISTORY: WHEELCHAIR-ADULT/HEMI/BLUE-STD FOR ALL               STA ST. NUM. 578P
                      AGE 1

                      REQUEST DATE      PATIENT NAME   SSN    VENDOR        AUG 29, 2000-SEP 28,
                      2000
                      SEP 25, 2000@11:56 PATIENT,FOUR     2750 Vendor SERIAL NBR:     QTY: 1
                      TOTAL COST:   23.00   INITIAL ISSUE
                      INITIATOR:     PROSPROVIDER,THREE

                      TOTAL DOLLARS SPENT ON THIS ITEM: $         23.00   TOTAL QUANTITY ISSUED:   1




Revised August 2011                      Prosthetics Basics User Manual                                      51
                               Search for Recalled Item (SE)
Overview


Introduction          The Search for Recalled Item (SE) option from the Display/Print Menu searches
                      the RECORD OF PROS APPLIANCE/REPAIR file (#660) for a recalled item.


Steps                 To search for a recalled item, follow these steps:

                        Step                                       Action
                         1       Type SE for the Search for Recalled Item (SE) option from the
                                 Display/Print Menu.
                          2      At the Site prompt, press <Enter> to accept the default Site or type
                                 two question marks to display a list and select a different site.
                          3      At the Beginning Date prompt, enter a date for the beginning of
                                 the date range of the data you want to view, and press <Enter>. (For
                                 instance, if you want a range of a year of data, enter T-365 for “Today
                                 minus 365 days from the current date.”)
                          4      At the Ending Date prompt, enter the end date of the date range of
                                 the data you want to view, and press <Enter>. (For instance, you can
                                 enter T for Today for the current date.)
                          5      At the Select one of the following prompts, a list of options
                                 display including: 1) Search by Serial Number or Lot
                                 Number or 2) Search by Item. Type the option that you want and
                                 press <Enter>.


Search for               23      Display/Print Patient 2319
                         TI      Transaction Inquiry
Recalled Item            IP      Print All Prosthetic Items
Screen                   BI      Print Prosthetic Billings for MAS
                         IH      Item History
                         SE      Search for Recalled Item
                         SI      Site Parameter Inquiry
                         VI      Vendor Inquiry

                      Select Display/Print Option: SE Search for Recalled Item
                      SITE: A 3456789012345678901234567890 LONG NAME//  499

                      Beginning Date: T-365 (SEP 28, 1999)
                      Ending Date: T (SEP 27, 2000)

                      Select one of the following:

                                 1          Search by Serial Number or Lot Number
                                 2          Search by Item

                      Enter response: <Enter>




Revised August 2011                      Prosthetics Basics User Manual                                    52
Search by Serial Number or Lot Number


Search patterns       Items issued through the Prosthetics stock program can be traced to an individual
                      patient if either the item’s lot or serial number was recorded at the time of the issue.
                      To use the Search by Serial Number or Lot Number option, some unique pattern
                      in either the lot or serial number must be known.

                      For example, to find all issues to patients receiving an item with the Serial Number
                      (or in the Lot Number) of 90-222-98, enter 90- at the “Enter Serial Number or Lot
                      Number:” prompt. A search of the database will begin and the results may be sent
                      to the screen or printer. Multiple results may display.

                      For this example, entering 90-222 or 222 would have given the same results.
                      Entering 222-90 would NOT have found these transactions since 222-90 is NOT a
                      pattern in either transaction’s Serial Number or Lot Number.

                      Note: You may also search by item name.


Steps                 To search for a recalled item, follow these steps:

                        Step                                       Action
                         1       Enter 1 for the Search by Serial Number or Lot Number.
                         2       At the Enter Serial Number or Lot Number prompt, you can
                                 enter partial information to begin the search.
                          3      At the Device prompt, press <Enter>. The following displays:
                                 Right Margin: 80//. Press <Enter> again.


Search by                  Select one of the following:
Serial Number                    1          Search by Serial Number or Lot Number
or Lot Number                    2          Search by Item
Screen                Enter response: 1 Search by Serial Number or Lot Number
                      Enter Serial Number or Lot Number: 9
                      DEVICE: <Enter> HOME//    TELNET    Right Margin: 80// <Enter>

                      ...HMMM, I'M WORKING AS FAST AS I CAN..

                      RECALLED ITEM REPORT
                      JUN 20, 1997-OCT 02, 2000 STA ST. NUM. 578                           PAGE 1
                      REQUEST DATE   PATIENT NAME   SSN   ITEM                 VENDOR

                      JUN 01, 2000     TEST,H          5612 TEST ITEM          PROSVENDOR,THREE
                      LOT NBR:                    SERIAL NBR: K0429

                                                          END OF REPORT




Revised August 2011                       Prosthetics Basics User Manual                                         53
Search by Item Number


Report                The Recalled Item Report displays the request date, patient name, SSN, item and
description           vendor.


Steps                 To search for a recalled item, follow these steps:

                        Step                                       Action
                         6       At the Select ITEM prompt, type either an item number or two
                                 question marks to display a list and then select one.
                          7      At the Device: HOME// prompt, press <Enter> twice to display the
                                 information to your terminal screen (or type SLAVE to print it).


Search for            Select one of the following:
Recalled Item                    1          Search by Serial Number or Lot Number
Screen                           2          Search by Item
(continued)           Enter response: 2    Search by Item Select ITEM: ??

                         Choose from:
                         3            **** THIS ITEM IS INACTIVE ****
                         7
                         9            **** THIS ITEM IS INACTIVE, USE ITEM NUMBER 11 ****
                         40
                         55
                         56

                      Select ITEM: 3
                           1   3       **** THIS ITEM IS INACTIVE ****
                           2   345-1234 55
                      CHOOSE 1-2: 1 <Enter>   3     **** THIS ITEM IS INACTIVE ****
                               ...OK? Yes// <Enter> (Yes)

                      DEVICE: HOME//   <Enter>    TELNET      Right Margin: 80// <Enter>

                                RECALLED ITEM REPORT          SEP 28, 1999-SEP 27, 2000    STA 499   PAGE 1
                      REQUEST DATE   PATIENT NAME   SSN       ITEM               VENDOR

                      MAY 19, 2000     PATIENT,TWO 8888 **SYRINGE-SUBCUTA         PROSVENDOR,THREE
                      LOT NBR:                   SERIAL NBR:

                      MAY 22, 2000     PATIENT,TWO 8888 **SYRINGE-SUBCUTA     PROSVENDOR,FIVE
                      LOT NBR:                   SERIAL NBR:

                      MAY 23, 2000     PATIENT,TWO     8888   **SYRINGE-SUBCUTA   PROSVENDOR,FIVE

                      LOT NBR:                    SERIAL NBR:

                                                           END OF REPORT


                                                                                        Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                   54
Search by Item Number, Continued


Example               The following is an example of the usefulness of the Search for Recalled Item
                      option:

                      A vendor calls the Prosthetic office to look for a patient’s name and/or purchase
                      order number but all they have is the item that was purchased and the date of the
                      purchase.

                      By using this option, you can locate the patient’s name and the item at the prompt
                      that asks for the beginning and ending date.

                      You would then access the patient’s 2319 which is located under the Display/Print
                          option.
                      Select the Appliance Transactions option.
                      Select the date given to you by the vendor and enter the number that matches the
                          date.
                      The number will show full entry, and you will be able to locate the purchase order
                          number.




Revised August 2011                      Prosthetics Basics User Manual                                    55
                                  Site Parameter Inquiry (SI)
Overview


Introduction          The Site Parameter Inquiry (SI) option from the Display/Print Menu should be
                      used to review your local site information.


Steps                 To inquire on a site parameter, follow these steps:

                        Step                                       Action
                         1        Type ST for the Search for Recalled Item (ST) option from the
                                  Display/Print Menu.
                          2       At the Site prompt, type two question marks to display a list and select
                                  a site.
                          3       At the Device: HOME// prompt, press <Enter> twice to display the
                                  information to your terminal screen (or type SLAVE to print it).


Site Parameter           23       Display/Print Patient 2319
                         TI       Transaction Inquiry
Inquiry Screen           IP       Print All Prosthetic Items
                         BI       Print Prosthetic Billings for MAS
                         IH       Item History
                         SE       Search for Recalled Item
                         SI       Site Parameter Inquiry
                         VI       Vendor Inquiry

                      Select Display/Print Option: SI <Enter> Site Parameter Inquiry

                      Select PROSTHETICS SITE PARAMETERS SITE NAME: ??

                         Choose from:
                         Hines Development System
                         Hines Development System2
                         CORKWELL VAMC
                         HINESTEST
                         SAN ANTONIO VAMC
                         ZZOJ VAMC VAMC

                      Select PROSTHETICS SITE PARAMETERS SITE NAME: H       <Enter>
                           1   Hines System Development
                           2   Hines System Development2
                      CHOOSE 1-2: 1 <Enter> Hines System Development

                      DEVICE: 1     <Enter>   P-SLAVE-CERA10    173C




Revised August 2011                      Prosthetics Basics User Manual                                      56
                                      Vendor Inquiry (VI)
Overview


Introduction          The Vendor Inquiry (VI) option from the Display/Print Menu provides a display of
                      all information contained in IFCAP’s Vendor file. Enter the vendor’s name and the
                      information is displayed. You can type two question marks to display a list of
                      vendors to select one.


Display/Print            23     Display/Print Patient 2319
                         TI     Transaction Inquiry
Menu Screen              IP     Print All Prosthetic Items
                         BI     Print Prosthetic Billings for MAS
                         IH     Item History
                         SE     Search for Recalled Item
                         SI     Site Parameter Inquiry
                         VI     Vendor Inquiry

                      Select Display/Print Option: VI     <Enter> Vendor Inquiry

                      Select VENDOR NAME: ?? <Enter>

                         Choose from:
                         1            PROSVENDOR,FOUR                                      NO:   1
                      ORD ADD:M AND M AVENUE                        FMS:
                              HACKETTSTOWN, NJ 07840                CODE:           FAX:555 555-1212
                      ****THIS VENDOR IS INACTIVE, NO REPLACEMENT VENDOR *****
                            PLEASE CHOOSE ANOTHER VENDOR
                         2            PROSVENDOR,FIVE                      PH:555 555-5555 NO:     2
                      ORD ADD:1ST AVE NO 22ND                       FMS:
                              HINES, IL 60141                       CODE:             FAX:

                         3            PROSVENDOR,THREE                        PH:555-555-5555     NO:       3
                      ORD ADD:CORPORATE ORDER ENTRY                    FMS:
                              ANY PARK, IL 60064                    CODE:              FAX:

                         4            PROSVENDOR,SIX                     EDI PH:555 555-5555 NO:        4
                      ORD ADD:7701 SOUTH ST                                FMS:TEST TEST
                              CHICAGO, IL 60620                           CODE:            FAX:

                         5            PROSVENDOR,SEVEN                   PH:555 555-5555   NO:    5
                      ORD ADD:7501 S PULASKI                             FMS:
                              CHICAGO, IL 60652                          CODE:FED000000    FAX:

                                      ^
                      Select VENDOR NAME: PROSVENDOR,SIX <Enter> PROSVENDOR,SIX EDIPH:555 555-
                      5555NO:
                          4
                      ORD ADD:7701 SOUTH ST                          FMS:TEST TEST
                              CHICAGO, IL 60620                     CODE:            FAX:

                               ...OK? Yes//    (Yes) <Enter>




Revised August 2011                     Prosthetics Basics User Manual                                          57
Vendor Inquiry Screen Output


Vendor Report         The Vendor report displays for the vendor selected. You can press <Enter> at the
                      Device prompt, to display the information to your terminal or type SLAVE to send it
                      to your printer for a hard copy.


Vendor Inquiry        DEVICE: <Enter> TELNET     Right Margin: 80// <Enter>
                      VENDOR LIST                                    OCT 3,2000 15:13      PAGE 1
Screen                ------------------------------------------------------------------------------

                      NUMBER: 4                               NAME: PROSVENDOR,SIX
                        ORDERING ADDRESS1: 7701 SOUTH CLAREMONT
                        ORDERING CITY: CHICAGO                ORDERING STATE: ILLINOIS
                        ORDERING ZIP CODE: 60620            PROCUREMENT CONTACT PERSON: PROVIDER,TEN
                        VENDOR PHONE NUMBER: (555) 555-5555   BILLING ADDRESS1: BILLING ADDRESS 1
                        BILLING ADDRESS2: BILLING ADDRESS 2   BILLING CITY: CHICAGO
                        BILLING STATE: ILLINOIS               BILLING ZIP CODE: 60620
                        BILLING PHONE NUMBER: 555-5555
                      TYPE OF OWNERSHIP (FY88): V   VIETNAM VETERAN - OWNED
                      SOCIOECONOMIC GROUP (FPDS): Q VIETNAM VET-OWNED SM
                      SOCIOECONOMIC GROUP (FPDS): S VETERAN-OWNED SM BUSINESS
                        BUSINESS TYPE (FPDS): SMALL           LABOR SURPLUS AREA?: YES
                        BUSINESS TYPE (FPDS-88): SMALL        IS A SF129 ON FILE?: YES
                        DATE OF SF129: OCT 23, 1992           GUARANTEED DELIVERY VENDOR?: NO
                        SPECIAL FACTORS: FAX#555-2509/FOB D   EDI VENDOR?: YES
                        VENDOR ID NUMBER: 77778




Revised August 2011                     Prosthetics Basics User Manual                                  58
                          Section 3: Purchasing Menu (PU)
Overview


Introduction          Creating the Prosthetics purchase order is an involved process and includes the
                      following:

                      It combines patient information, vendor, item, obligation, and cost information on a
                           single purchasing document.

                      It is integrated with six other VISTA applications including: PSAS, IFCAP, Consult
                           Tracking, CPRS, Patient Care Encounters, DSS and Billing. They are integrated
                           by exchange of data between applications.

                      It is also different because of the structure of the National Prosthetics Patient
                           Database (NPPD) and the NPPD requirements.

                      Creating the PSAS purchasing document using IFCAP interface is a seamless
                         process.

                      PSAS data (patient name, SSN, address, and phone number) are automatically
                         printed on PSAS obligation document.


Background            PSAS has developed a customized Purchasing Menu in the prosthetics software
                      package in VISTA, which calls into IFCAP, in order to alleviate the need to switch
                      to and from various packages in VISTA or various screens. This reduced processing
                      time of procuring devices/appliances and services for direct patient care.

                      The National Prosthetic Patient Database (NPPD) requires various fields, which
                      are patient specific, in order to ensure we are adhering to eligibility criteria, and
                      maintaining prescription, diagnosis, ordering, vendor, item, and accounting data is
                      captured on the patients record. The need for one point of entry and seamless
                      entry/order processing has proven effective in reducing delays and fast effective
                      processing of orders.

                      PSAS is held to a five-day time limit in processing an order (again since it is for
                      direct patient care), and VISN Directors performance standards state such.


Prosthetics           The Purchasing Menu (PU) is accessed from the Prosthetic Official’s Menu.
System

                                                                                          Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                      59
Overview, Continued


VA Forms              Purchasing interfaces with IFCAP into the IFCAP 1358 module. Forms printed
                      include the following:

                      VAF 10-2421, Prosthetics Authorization and Invoice
                      Form Letter 10-55, Authority to Exceed Amount on Service Card.

                      For tracking transactions associated with purchasing, Prosthetics will accommodate:

                      VAF 10-2520, Prosthetic Service Card Invoice
                      VAF 10-2914, Prescription and Authorization for Eyeglasses - Computer entry of
                          eyeglass prescriptions has been automated.
                      No-Form, Pickup/Delivery Charges
                      Request for Estimate (FL 10-55)
                      Patient Notification Letter.

                      Listed below are all of the menus and sub-menus that you will use for purchasing
                      purposes. If the system does not allow you to access an option, contact your Fiscal
                      Service and inform them that you need access to fund control points.


Purchasing            Select Prosthetic Official's Menu Option: PU        Purchasing

Menu (PU)                EN     Enter New Request ...
                         SI     Stock Issues ...
                         RP     Reprints ...
                         RE     Record 2237 Purchase to 2319
                         ED     Edit/Delete 2237 from 10-2319
                         CA     Cancel a Transaction
                         CO     Close Out
                         CPC    Cancel Purchase Card Transaction
                         CPO    Reconcile/Close Out Purchase Card Transaction
                         ED2    Edit 2319
                         ED2C   Edit 2319 (Vendor,QTY,Cost)
                         EDPC   Edit Purchase Card Transaction
                         HI     Add Historical Data
                         HID    Delete Historical Data Entry
                         LI     List Open 1358 Prosthetic Transactions
                         LII    List Open 1358 Transactions By Initiator
                         LPC    List Open Purchase Card Transactions
                         LPCI   List Open Purchase Card Transactions By Initiator
                         LPS    Purchase Card Summary Sheet

                      Select Purchasing Option:



In this manual        The following topics are covered under the Purchasing Menu:

                                                    Topic                                      See Page
                      List Open 1358 Prosthetic Transactions (LI)                                 61
                      Close Out (CO)                                                              63
                      Enter a New Request (EN)                                                    64

                                                                                       Continued on next page



Revised August 2011                      Prosthetics Basics User Manual                                     60
Overview, Continued


Stock Issues          There is a separate Stock Issues User Manual that was developed with Patch
                      RMPR*3*61 the Inventory/Bar Coding enhancement. Therefore this menu and the
                      menu options will not be explained in this basic manual.


Purchase Cards        There is also a Purchase Cards User Manual that is available from the Vista
                      Document Library for you to download and therefore will not be explained in this
                      basic manual.

                      The Purchase Cards User Manual also documents the following Purchasing
                      options:

                      Purchase Card Form (PC) – from the Enter New Request (EN) Menu
                      CPC - Cancel Purchase Card Transaction
                      CPO - Reconcile/Close Out Purchase Card Transaction
                      LPC - List Open Purchase Card Transactions
                      LPCI - List Open Purchase Card Transactions By Initiator
                      LPS - Purchase Card Summary Sheet
                      Reprint a Purchase Card Form (PCR) – from the Reprints (RP) Menu




Revised August 2011                     Prosthetics Basics User Manual                                   61
List Open 1358 Prosthetic Transactions (LI)


Introduction          The List Open 1358 Prosthetic Transactions (LI) option produces a report that
                      will print the open 1358 transactions in the Prosthetics Package, sorted by initiator.
                      However, it will not include manual transactions that were created in the IFCAP
                      1358 module. Once the transaction has been closed out, it will not appear on this
                      report.


Purchasing               EN      Enter New Request ...
                         SI      Stock Issues ...
(PU) Menu                RP      Reprints ...
                         RE      Record 2237 Purchase to 2319
                         ED      Edit/Delete 2237 from 10-2319
                         CA      Cancel a Transaction
                         CO      Close Out
                         CPC     Cancel Purchase Card Transaction
                         CPO     Reconcile/Close Out Purchase Card Transaction
                         ED2     Edit 2319
                         ED2C    Edit 2319 (Vendor,QTY,Cost)
                         EDPC    Edit Purchase Card Transaction
                         HI      Add Historical Data
                         HID     Delete Historical Data Entry
                         LI      List Open 1358 Prosthetic Transactions
                         LII     List Open 1358 Transactions By Initiator
                         LPC     List Open Purchase Card Transactions
                         LPCI    List Open Purchase Card Transactions By Initiator
                         LPS     Purchase Card Summary Sheet

                      Select Purchasing Option: LI <Enter> List Open 1358 Prosthetic Transactions
                      This report lists open purchasing transactions created in the
                      Prosthetic Package. It will not include manual transactions done
                      in the IFCAP 1358 module.

                      SITE: Hines Development System//        <Enter>                   499


                      Starting Date: T-300 <Enter>   (JAN 31, 2001)
                      Ending Date: T <Enter>   (NOV 27, 2001)
                      DEVICE: HOME// <Enter>    TELNET    Right Margin: 80// <Enter>

                      …Hmmm, I’m working as fast as I can




Site                  Multiple division sites are available


Date prompts          The date prompts determine the range of dates for which the report will be produced.

                                                                                         Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                        62
List Open 1358 Prosthetic Transactions (LI), Continued


Output                Here’s the output:


Screen        FROM: JAN 31, 2001-NOV 27, 2001           OPEN 1358 TRANSACTIONS         STA 499    PAGE 1
output        PATIENT NAME       SSN    OBLIGATION REQUEST DATE              VENDOR       ITEM        ITEM COST
              PATIENT,FIVE      0005   A20012-0132 FEB 02, 2001            VENDOR,EIGHT TEST ITEM        0.01
              PATIENT,FOUR      0004   A20012-0133 FEB 05, 2001            VENDOR,THREE TEST ITEM        0.01
              PATIENT,FIVE      0005   A20012-0134 FEB 06, 2001            VENDOR,THREE TEST ITEM        0.01
              PATIENT,FIVE      0005   A20012-0135 FEB 06, 2001            VENDOR,THREE EYEGLASSES       0.01
              PATIENT,FOUR      0004   A20012-0140 MAY 22, 2001            VENDOR,NINE *SHIPPING         1.00
                                                                                         OXYGEN DEV      1.00
              PATIENT,FOUR      0004   A20012-0141      JUL   10,   2001   VENDOR,TEN    OXYGEN DEV      1.00
              PATIENT,FOUR      0004   A20012-0142      JUL   16,   2001   VENDOR,THREE *DELIVERY        1.00
              PATIENT,F0UR      0004   A20012-0143      JUL   19,   2001   VENDOR,THRE   TEST ITEM       2.00
              PATIENT,FOUR      0004   A20012-0144      JUL   19,   2001   VENDOR,TEN    DELIVERY




Revised August 2011                        Prosthetics Basics User Manual                                     63
Close Out (CO)


Menu                  The Close Out (CO) option is used to close out transactions when invoices are
description           received from the vendor. This will update the actual VAF 1358 account balance.


Screen sample            EN     Enter New Request ...
                         SI     Stock Issues ...
                         RP     Reprints ...
                         RE     Record 2237 Purchase to 2319
                         ED     Edit/Delete 2237 from 10-2319
                         CA     Cancel a Transaction
                         CO     Close Out
                         CPC    Cancel Purchase Card Transaction
                         CPO    Reconcile/Close Out Purchase Card Transaction
                         ED2    Edit 2319
                         ED2C   Edit 2319 (Vendor,QTY,Cost)
                         EDPC   Edit Purchase Card Transaction
                         HI     Add Historical Data
                         HID    Delete Historical Data Entry
                         LI     List Open 1358 Prosthetic Transactions
                         LII    List Open 1358 Transactions By Initiator
                         LPC    List Open Purchase Card Transactions
                         LPCI   List Open Purchase Card Transactions By Initiator
                         LPS    Purchase Card Summary Sheet

                      Select Purchasing Option: CO <Enter>   Close Out
                      SITE: Hines Development System//   <Enter>                 499
                      Select OBLIGATION NUMBER:    499-A20012 07-01-97          1358    Obligated - 1358
                                   FCP: 910     $ 2000.00
                      1358 Balance is $ 2911.23
                      Select PATIENT:    8-16-2001   PROSPATIENT,FOUR            REF: 0167   SHOE COMPONENTS


                           PROSPATIENT,FOUR                000-00-0004         499-A20012
                      ------------------------------------------------------------------------------

                           ITEM: 913   SHOE COMPONENTS            AMIS: 20
                           PSAS HCPCS CODE: L3455 SHOE HEEL NEW LEATHER STANDA
                           CPT MODIFIER: LT,RT
                           REMARKS: TESTING

                           DESCRIPTION: TESTING
                           SERIAL NUMBER:
                           UNIT COST: 20       UNIT OF ISSUE: EA          QTY: 1    ITEM COST:       20.00
                           TYPE: INITIAL       CATEGORY: SC/OP           SPECIAL CATEGORY:

                                                SUB TOTAL:                                       $   20.00

                                                % DISCOUNT: 5                                    $    1.00
                                                SHIPPING CHARGE:                                 $    2.00

                                                TOTAL COST:                                      $   21.00


                      Ready to Close-Out Transaction? No// Y   <Enter>          (Yes)
                      CLOSE-OUT REMARKS: TESTING <Enter>
                      Updated 1 10-2319 record for this Veteran

                           Closed out Transaction




Revised August 2011                     Prosthetics Basics User Manual                                       64
                                   Enter New Request (EN)
Overview
Menu                  In order to use the Enter New Request (EN) option or to enter a new transaction,
description           you must choose one of the menu options (purchasing forms) below. All of the
                      options listed under this menu are similar in several ways. Each form type will, upon
                      posting, update the patient’s electronic 10-2319, and record the transaction to the
                      1358 obligation that you choose.

                      Once posted, these requests may only be closed out or cancelled. After you begin
                      input into the computer, these forms must be completed to the point of posting to the
                      1358 obligation and patient's 10-2319 record. If the form is not completed, exiting
                      the program during input of one of these forms will cause the transaction to be
                      deleted. (This is unlike IFCAP where a transaction may be started and later edited.)

                      Note: Prosthetics purchasing forms are not saved in the computer for editing at a
                      later time.


Enter New                EN      Enter New Request ...
                         SI      Stock Issues ...
Request Menu             RP      Reprints ...
(EN)                     RE      Record 2237 Purchase to 2319
                         ED      Edit/Delete 2237 from 10-2319
                         CA      Cancel a Transaction
                         CO      Close Out
                         CPC     Cancel Purchase Card Transaction
                         CPO     Reconcile/Close Out Purchase Card Transaction
                         ED2     Edit 2319
                         ED2C    Edit 2319 (Vendor,QTY,Cost)
                         EDPC    Edit Purchase Card Transaction
                         HI      Add Historical Data
                         HID     Delete Historical Data Entry
                         LI      List Open 1358 Prosthetic Transactions
                         LII     List Open 1358 Transactions By Initiator
                         LPC     List Open Purchase Card Transactions
                         LPCI    List Open Purchase Card Transactions By Initiator
                         LPS     Purchase Card Summary Sheet

                      Select Purchasing Option: EN   <Enter>   Enter New Request
                         24     2421 Form
                         25     2520 Transaction without printing 10-55
                         10     10-55 PSC Form
                         29     2914 Eyeglass Record
                         NF     Create a No-Form Daily Record
                         PD     Pickup and Delivery Charges
                         PC     Purchase Card Form
                         SS     Purchase Card Site Parameter



                                                           Topic                                See Page
                      2421 Form (24)                                                                65
                      2520 Transaction without printing 10-55                                       75
                      10-55 PSC Form (10)                                                           77
                      2914 Eyeglass Record (29)                                                     80

                                                                                           Continued on next page




Revised August 2011                        Prosthetics Basics User Manual                                     65
Enter a 2421 Form (24)


Introduction          With the 2421 Form (24) option, the user will create a 2421 Form for a selected
                      patient. This form will update the patient’s electronic 10-2319, and record the
                      transaction to the 1358 obligation that you choose. Once posted, this request may
                      only be closed out or cancelled.


When do you           You must use the 2421 Form (24) option when a vendor does NOT accept the
use this option?      government purchase card. (This is another form of a Prosthetics Purchase Order
                      using a 1358.)


What is the           After you access the 2421 Form (24) option, this form must be completed to the
process?              point of posting to the 1358 obligation and patient's 10-2319 record. If it is not
                      completed, exiting the program during input will cause the transaction to be deleted.

                      You will be prompted to enter the site, substation, obligation number, patient, and
                      disability code(s) if none exists. If the patient already has disability codes, they will
                      display.

                      You may view any of the 10-2319 patient screens (patient demographics, clinic
                      enrollments/correspondence, entitlement information, appliance transactions, auto
                      adaptive information, critical comments, add/edit disability code).

                                                                                          Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                          66
Enter a 2421 Form (24), Continued


Obligation            This is the 1358 Number. This prompt will display: This will Create a 10-2421 Do you
Number                wish to Continue? Yes//. By pressing <Enter>, you accept the default answer of YES
                      and are asked to select the Prosthetics 1358 patient.

                      The Obligation Number is also considered all of the following: Procurement &
                      Accounting Transactions Purchase Order Number, or method of processing, or
                      Depot Voucher No., or Supply Status, or Supply Status Order, or FCP or vendor, or
                      Purchase Card holder, or Requisition No.(Supply), or Issue Voucher No.(Supply), or
                      Issue Voucher No.(Fiscal), or Inventory/Distribution Point, or ISMS Order No.


Steps                 To enter a 2421 Form (24), follow these steps:


                        Step                                      Action
                         1      Select the Form Type (i.e., 2421 Form (24)).
                         2      Enter the Site (if a multi-site facility).
                         3      Enter the 1358 Obligation Number.


2421 Form             SITE: Hines Development System//    <Enter>                    499

screen                Select OBLIGATION NUMBER: ?? <Enter>
                             Choose from:
                         499-A20003      11-24-95 1358    Cancelled Order
                                    FCP: 910     $ 0.00
                         499-A20010      01-04-00 1358    Order Not Completely Prepared
                                    FCP: 910     $ 0.00
                         499-A20012      07-01-97 1358    Obligated - 1358
                                    FCP: 910     $ 2000.00

                      Select OBLIGATION NUMBER: 499-a20012    07-01-97 1358    Obligated - 1358
                                   FCP: 910     $ 2000.00
                      1358 Balance is $ 2984.97
                      This will Create a 10-2421 Do you wish to Continue? Yes// Y <Enter> (Yes)


                                                                                     Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                   67
Enter a 2421 Form (24), Continued


Prosthetic            The patient selected must be in both the MAS patient file and the Prosthetic Patient
patient               file. If the patient is not in the Prosthetic Patient file, but is in the MAS Patient file,
                      you may enter the patient into the Prosthetic Patient file at this time.

                      The current Disability codes will be displayed for the selected patient. If there is no
                      Prosthetic Disability Code entered for the patient, you must do so prior to continuing.


Steps                 To continue to enter a 2421 Form (24), follow these steps:


                        Step                                     Action
                         4        Enter the Prosthetic Patient. The Disability Codes will display.
                         5        Enter the Date or press <Enter> to accept the default setting.
                         6        Select a Vendor.


Screen Sample         Select PROSTHETIC PATIENT: PATIENT,FOUR <Enter> PATIENT,FOUR                    12-27-50
                      000654321         YES     SC VETERAN
                       Enrollment Priority: GROUP 2    Category: IN PROCESS    End Date:

                                ...OK? Yes// <Enter>      (Yes)
                                SUPPORT ISC

                      Current Disability Codes are:
                      AMP/LS         INPATIENT      S/C
                      BLD/TRE        EMPLOYEE       NSC
                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue:

                      DATE REQUIRED: T+30//      <Enter> (AUG 18, 2001)

                      VENDOR:??
                           Enter the Vendor the item is being purchased from.
                      VENDOR: VENDOR,THREE   <Enter>   VENDOR,THREE      PH:555 555-5555              NO:    3
                      ORD ADD:CORPORATE ORDER ENTRY                 FMS:
                              PARK, IL 60064                 CODE:             FAX:
                                ...OK? Yes// <Enter> (Yes)



Date Required         Press <Enter> at the Date Required prompt to accept the default response, which is
                      today’s date plus 30 days. If another date is necessary (i.e., item is needed in one
                      week), enter that date.


Vendor                Select the Vendor for the item you are purchasing. If the computer does not
                      recognize the vendor you select, you must first enter the vendor into the IFCAP file.

                      You may enter an ^ to exit the program at this time if you need to enter data into
                      either of these files.

                                                                                            Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                            68
Enter a 2421 Form (24), Continued


Contract/BOA          If the item you are purchasing is on contract with the vendor, enter the Contract
Number                Number at the prompt.


Type of               Enter a question mark (?) to view the choices for the Type of Transaction prompt.
Transaction           They are the following:

                      I    Initial Issue
                      R    Replace
                      S    Spare
                      X    Repair


Steps                 To continue to enter a 2421 Form (24), follow these steps:


                          Step                                       Action
                           7      Select a Contract/BOA Number.
                           8      Select a Type of Transaction.


2421 Form             Select CONTRACT/BOA NUMBER: ?? <Enter>
Screen                   Choose from:
(continued)              V797P-5640M               --        EXP. DATE: 12-31-95         MOL$100000
                      CONTRACT
                         V797P-5894M               02-09-00        EXP. DATE: 05-04-01
                      MIN$1000/MOL$15000
                        CONTRACT


                      Select CONTRACT/BOA NUMBER: v797p-5640M               <Enter> --      EXP. DATE:
                      12-31-95     MOL $100000     CONTRACT

                      TYPE OF TRANSACTION: I            <Enter>   INITIAL ISSUE


                                                                                         Continued on next page




Revised August 2011                        Prosthetics Basics User Manual                                   69
Enter a 2421 Form (24), Continued


Patient               The Patient Category includes the following:
Category
                      SC/OP (Service connected/Outpatient)
                      SC/IP (Service connected/Inpatient)
                      NSC/IP (Non-service connected/Inpatient)
                      NSC/OP (Non-service connected/Outpatient)

                      Note: If you select the NSC/OP option, a prompt for Special Category appears
                      requiring you to select from one of four options (i.e., Special Legislation, AA, etc.)


Item                  This is the item entered into the Prosthetic Item master list. You can search for an
                      item using the question mark processing feature.


PSAS HCPCS            Enter the appropriate HCPCS (Health Care Financing Administration Common
                      Procedure Coding System) code. Try the HCPCS, E1399 if unknown. This field
                      should have the HCPCS code for the Item you are selecting. HCPCS is a uniform
                      method to report professional services, procedures and supplies for healthcare
                      providers and medical suppliers.


Steps                 To continue to enter a 2421 Form (24), follow these steps:
(continued)


                        Step                                     Action
                         9       Enter the Patient Category. (If the veteran is NSC/OP, then select
                                 a Special Category.)
                         10      Select the Item to be Issued or Repaired.
                         11      Select the PSAS HCPCS and if necessary a CPT Modifier.


2421 Form             PATIENT CATEGORY: ??
                      Enter a code from the list.
screen
(continued)                Select one of the following:
                                1         SC/OP
                                2         SC/IP
                                3         NSC/IP
                                4         NSC/OP

                      PATIENT CATEGORY: NSC/IP <Enter>

                      Select ITEM: 913         SHOE COMPONENTS
                               ...OK? Yes//    <Enter> (Yes)

                      PSAS HCPCS: L3455 <Enter>     SHOE HEEL NEW LEATHER STANDA
                      Enter a CPT MODIFIER for HCPCS L3455: (LT/RT/B): Both Left and Right

                                                                                         Continued on next page



Revised August 2011                      Prosthetics Basics User Manual                                        70
Enter a 2421 Form (24), Continued


Brief/Extended        You can type a brief description of the item for that specific vendor. This
Description of        description will print on the 10-2421 form for use by the vendor to determine what
Item                  item is to be provided to the veteran.

                      At the Extended Description, you can further describe the item for the vendor in a
                      text editor at the Edit? prompt.


Steps                 To continue to enter a 2421 Form (24), follow these steps:
(continued)


                        Step                                      Action
                         12      Enter a brief and an extended description of the item (for the vendor).
                         13      Enter the Quantity to be Purchased.
                         14      Enter Unit Cost.
                         15      Enter Unit of Issue.
                         16      Enter Remarks (2310 and 1358).
                         17      Establish a Shipping Charge (optional).


2421 Form             BRIEF DESCRIPTION OF ITEM (for Vendor): SHOE HEEL
screen                EXTENDED DESCRIPTION:
(continued)             No existing text
                        Edit? NO//

                      QTY: 1 <Enter>
                      UNIT COST: 2500 <Enter>
                      UNIT OF ISSUE: ea <Enter>           EACH

                      REMARKS (2319 and 1358):
                      ----------------------------------
                      EST. SHIPPING CHARGE:



                          Prompt                                        Description
                      Quantity              Enter the number of the item you want to order – total amount
                                            of units issued for this item.
                      Unit Cost             Enter the cost of one item to be purchased.
                      Unit of Issue         This field uses data from the IFCAP system (i.e., ea for Each).
                      Remarks               Any Remarks you would like printed on the 1358 Obligation
                                            form and the 10-2319 should be entered here.
                      Est. Shipping         The estimated shipping charge when the transaction is
                      Charge                created. This field only holds the estimate, not the actual
                                            charge.

                                                                                        Continued on next page



Revised August 2011                      Prosthetics Basics User Manual                                    71
Enter a 2421 Form (24), Continued


Percent               Contains the percent discount for the purchase. Estimated Cost and Actual Cost are
Discount              calculated with the percent Discount.


Deliver To            You have four selections of delivery locations to choose one.


Steps                 To continue to enter a 2421 Form (24), follow these steps:
(continued)


                        Step                                      Action
                         18      Enter a Percent Discount (if applicable).
                         19      Select one of the following to Deliver To:
                                 Veteran
                                 VAMC Warehouse
                                 Prosthetics
                                 Other
                         20      Answer Yes or No at the following prompt: Are you ready to POST to
                                 IFCAP and 10-2319 NOW? No//


2421 Form             PERCENT DISCOUNT: <Enter>
                      DELIVER TO: ?? <Enter>
screen                Enter a code from the list.
(continued)
                           Select one of the following:
                                1         VETERAN
                                2         VAMC WAREHOUSE
                                3         PROSTHETICS
                      OTHER

                      DELIVER TO: PROSTHETICS <Enter>

                      Are you ready to POST to IFCAP and 10-2319 NOW? No// NO <Enter> (No)




Are you ready         The prompt, Are you ready to Post to IFCAP and the 2319
to Post?              now?//No displays. The default answer for posting will always be NO. Accept the
                      default answer by pressing the <Enter> key, so you may verify that the information
                      entered on the request is correct. The data entered displays for your review.

                      If information is not correct, you have the option to edit the transaction as shown in
                      the example on the next page.

                                                                                         Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                        72
Enter a 2421 Form (24), Continued


Display Entry         The data entered displays below for your review if you accepted the default of NO at
                      the Are you ready to Post to IFCAP and 10-2319 NOW? prompt.


2421 Form                  PROSPATIENT,FOUR        000-00-0004         499-A20012
                      -----------------------------------------------------------------------------
screen
(continued)                ITEM: 903   TEST ITEM                     AMIS: 05 D
                           PSAS HCPCS CODE: VENDOR,FOUR    HEART PACEMAKER, PERMANENT
                           CPT MODIFIER: GX

                           DELIVER TO: PROSTHETICS

                           DESCRIPTION: Heart Pacemaker, Permanent
                           SERIAL NUMBER:
                           UNIT COST: 2500     UNIT OF ISSUE: EA   QTY: 1    ITEM COST: 2500.00
                           TYPE: INITIAL       CATEGORY: NSC/IP   SPECIAL CATEGORY:

                                                SUB TOTAL:                                  $2500.00

                                                % DISCOUNT:
                                                SHIPPING CHARGE:                            $   0.00

                                                TOTAL COST:                                 $2500.00


                      Enter Item to Edit: 903      TEST ITEM
                               ...OK? Yes// <Enter> (Yes)


                                                                                      Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                   73
Enter a 2421 Form (24), Continued


Edit the form         You can now edit the prompts if you need to change anything on the order. Press
                      <Enter> to view each prompt and accept the default entry shown.


Steps                 To continue to enter a 2421 Form (24), follow these steps:
(continued)


                        Step                                      Action
                         21     Press <Enter> for each prompt that you do not want to edit.
                         22     None of the fields have been edited in the example below because the
                                information is correct. When you are asked again Are you Ready
                                to POST to IFCAP and 10-2319 NOW? NO// you can
                                answer YES.
                         23     A YES response at the Would you like to print the Privacy Act
                                Statement? will print an additional page to the 10-2319.
                         24     At the prompt, Would you like to print a Patient
                                Notification letter? A YES response will print the Patient
                                Notification letter on the purchasing printer defined in the Site Parameter
                                File. You may also print the Patient Notification letter from the Reprint
                                2421 Form (24) option from the Reprints (RP) Menu.


2421 Form             TYPE OF TRANSACTION: INITIAL ISSUE// <Enter>
                      PATIENT CATEGORY: NSC/IP// <Enter>
screen                ITEM: TEST ITEM// <Enter>
(continued)           PSAS HCPCS: SI501// <Enter>
                      BRIEF DESCRIPTION: Heart Pacemaker, Permanent      Replace   <Enter>
                      EXTENDED DESCRIPTION: <Enter>
                        No existing text
                        Edit? NO// <Enter>
                      QTY: 1// <Enter>
                      UNIT COST: 2500// 2 <Enter>
                           ** Total for Previous Item(s) is $2500
                           ** Total With This Amount is $2
                      UNIT OF ISSUE: EA// <Enter>
                      REMARKS: <Enter>
                      EST. SHIPPING CHARGE: <Enter>
                      PERCENT DISCOUNT: <Enter>
                      DATE REQUIRED: AUG 18,2001// <Enter>
                      DELIVER TO: PROSTHETICS// <Enter>

                      Enter Item to Edit:

                      Are you ready to POST to IFCAP and 10-2319 NOW? No// Y <Enter> (Yes)
                      Would you like to print the Privacy Act Statement? Yes// Y <Enter> (Yes)
                      Would you like to print a Patient Notification letter? No// <Enter>  (No)
                           Posting Now ...
                           1358 Transaction has been assigned Number: 499-A20012-0143
                           Updated 10-2319
                      DEVICE: HOME// <Enter>    TELNET    Right Margin: 80// <Enter>

                                                                                       Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                        74
Enter a 2421 Form (24), Continued


Final Output          Below is the output of the data from the 2421 Form (24) option. Then the Suspense
                      Processing (SU) screen displays and allows you to perform an action on a Suspense
                      item and link it to the item(s) you just ordered through the Stock Issues (SI) Menu.


2421 Form (24)        OMB Number 2900-0188           Estimated Burden: 4 minutes
                             ***ORIGINAL COPY AND COMMERCIAL INVOICE MUST BE SUBMITTED***
Screen – Final                       TO THE VAMC PROSTHETIC ACTIVITY LISTED BELOW
Output                ______________________________________________________________________________
                      Department of Veterans Affairs|Prosthetics Authorization for Items or Services
                      ------------------------------------------------------------------------------
                      1. Name and Address of Vendor            2. Name and Address of VA Facility
                           PROSVENDOR,THREE                 Hines Development System (499/121)
                           CORPORATE ORDER ENTRY               TEST 2
                           PO BOX 1140                         HINES, IL 60142
                           ANY PARK,IL 60064
                           (800) 255-5162                      222
                      ------------------------------------------------------------------------------
                      3. Veterans Name (Last, First, MI)       4. Date of Authorization
                         PROSPATIENT,FOUR                             JUL 19, 2001
                      ------------------------------------------------------------------------------
                      5. Veterans Address                      6. Date Required
                           100 HOLLYWOOD                             AUG 18, 2001
                           HOLLYWOOD,CALIFORNIA                --------------------------------------
                                                               9. Authority For Issuance CFR 17.115
                                                                   CHARGE MEDICAL APPROPRIATION
                      ------------------------------------------------------------------------------
                      7. Claim Number 000654322P               8. SSN 000-00-0004
                      ------------------------------------------------------------------------------
                      10. Statistical Data           11. FOB Point    12. Discount   13. Delivery Time
                      NSC/IP                             DEST            %                30 Days
                                                     ------------------------------------------------
                                                     14. Delivery To: PROSTHETICS
                      ------------------------------------------------------------------------------
                                       15. DESCRIPTION OF ITEMS OR SERVICES AUTHORIZED
                      ------------------------------------------------------------------------------
                      ITEM NUMBER           DESCRIPTION/NOMENCLATURE     QUANTITY UNIT UNIT     AMOUNT
                                                                          ORDERED         PRICE
                      ------------------------------------------------------------------------------
                      #1. Heart Pacemaker, Permanent                          1     EA   2.00     2.00
                      ------------------------------------------------------------------------------
                      16. Contract Number:                                           Subtotal:    2.00
                          ACCT.#: 17000000         Discount $ 0.00 Shipping: 0.00 Total $         2.00
                      ------------------------------------------------------------------------------
                      17. Signature and Title of 18. DATE     19. Signature and Title of      20. Date
                           Requesting Official                Contracting/Accountable Officer
                           PROSPROVIDER1,ONE                     PROSPROVIDER,FOUR
                      ------------------------------------------------------------------------------
                                                Order and Receipt Action
                      ------------------------------------------------------------------------------
                      21. Order Number 22. Date of Order 23. Date Item Received       24. Date
                      Delivered
                         499-A20012-0143     JUL 19, 2001
                      ------------------------------------------------------------------------------
                      25. The articles or services listed herein have been received, or rendered
                      ordered in the quantity and quality specified originally or as shown by
                      authenticated changes, except as noted.
                                                               Signature of Veteran or VA Official




Revised August 2011                     Prosthetics Basics User Manual                                   75
Enter a 2520 Transaction without Printing 10-55 (25)


Description           From the Purchasing (PU) Menu and the Enter New Request (EN) Menu, you
                      can access the 2520 Transaction without Printing (25) option. This is used for
                      VAF 10-2520 PSC transactions that are under $300.00 and do not have an FL 10-55.
                      It will then post to the VAF 1358 and patient's VAF 10-2319 record.


Screen sample            24     2421 Form
                         25     2520 Transaction without printing 10-55
                         10     10-55 PSC Form
                         29     2914 Eyeglass Record
                         NF     Create a No-Form Daily Record
                         PD     Pickup and Delivery Charges
                         PC     Purchase Card Form
                         SS     Purchase Card Site Parameter

                      Select Enter New Request Option: 25 <Enter> 2520 Transaction without printing
                      10-55
                      SITE: Hines Development System// <Enter>                  499

                      Select OBLIGATION NUMBER: 499-A20012     07-01-97 1358   Obligated - 1358
                                   FCP: 910      $ 2000.00
                      1358 Balance is $ 2570.23
                      This will Create ALL OTHER Do you wish to Continue? Yes// <Enter> (Yes)
                      Select PROSTHETIC PATIENT:     PATIENT,FOUR <Enter>    SUPPORT ISC      12-27-
                      50    00012275
                      0P     YES     SC VETERAN

                      Current Disability Codes are:

                      AMP/LS         INPATIENT      S/C
                      BLD/TRE        EMPLOYEE       NSC
                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue:
                      Enter 'W' for WHEELCHAIR, 'O' for BRACE, 'B' for BLIND AIDS, 'A' for ART.
                      LIMBS
                      Select PSC ITEM CATEGORY: ?? <Enter>

                      CHOOSE FROM:
                           W         WHEELCHAIR
                           O         BRACE
                           B         BLIND AID
                           A         ARTIFICIAL LIMB
                      Enter 'W' for WHEELCHAIR, 'O' for BRACE, 'B' for BLIND AIDS, 'A' for ART.
                      LIMBS
                      Select PSC ITEM CATEGORY: W
                      You will not be able to exceed an item repair cost of more than $100.00.

                      Add/Edit/View Patient PSC? No// Y <Enter>          (Yes)

                      Select PSC ISSUE CARD: ?? <Enter>
                         1            MAY 22, 2000 TEST        345-678

                              You may enter a new PSC ISSUE CARD, if you wish
                              This is the date the PSC card was issued.

                      Select PSC ISSUE CARD: 1 5-22-2000 TEST            345-678
                      PSC ISSUE CARD DATE: MAY 22,2000// <Enter>


                                                                                   Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                76
Enter a 2520 Transaction without Printing 10-55 (25), Continued


Screen sample         ITEM: EYEGLASSES// ?? <Enter>
                              This is the PSC item issued to the patient.
(continued)
                        Choose from:
                        3            **SYRINGE-SUBCUTANEOUS-3IN     **** THIS ITEM IS INACTIVE ****
                        55            WHEELCHAIR-ADULT/HEMI/BLUE-STD FOR ALL PATIENTS
                        56            WHEELCHAIR-CLASSIC-18X16
                        59            EYEGLASSES
                        99            OXYGEN CONCENTRATOR
                        100           OXYGEN DEVICE
                        903           TEST ITEM
                        912           WHEELCHAIR GLOVES
                        913           SHOE COMPONENTS
                        921           WHEELCHAIR - ELECTRIC
                        922           WHEELCHAIR - MANUAL
                        925           SHOES
                        10000         EYEGLASSES

                      ITEM: EYEGLASSES// <Enter>
                      DETAILED DESCRIPTION: TEST// <Enter>
                      SERIAL NUMBER: 345-678// <Enter>

                      Select PSC ISSUE CARD: ?? <Enter>
                         1            MAY 22, 2000 TEST       345-678

                              You may enter a new PSC ISSUE CARD, if you wish
                              This is the date the PSC card was issued.

                      Select PSC ISSUE CARD: 1   <Enter>   5-22-2000 TEST   345-678

                      PSC ISSUE CARD DATE: MAY 22,2000// <Enter>
                      ITEM: EYEGLASSES// <Enter>
                      DETAILED DESCRIPTION: TEST// <Enter>
                      SERIAL NUMBER: 345-678// <Enter>
                      Select PSC ISSUE CARD: 1 <Enter>    5-22-2000 TEST    345-678
                      PSC ISSUE CARD DATE: MAY 22,2000// <Enter>
                      ITEM: EYEGLASSES// <Enter>
                      DETAILED DESCRIPTION: TEST// <Enter>




Revised August 2011                    Prosthetics Basics User Manual                             77
10-55 PSC Form (10)


Description           From the Purchasing (PU) Menu and the Enter New Request (EN) Menu, you
                      can access the 10-55 PSC Form (10). This will create a new FL 10-55 form and
                      post purchasing data to patient's VAF 10-2319 record and update the Service's VAF
                      1358 obligation.


Sample 10-55             24     2421 Form
                         25     2520 Transaction without printing 10-55
PSC Form (10)            10     10-55 PSC Form
                         29     2914 Eyeglass Record
                         NF     Create a No-Form Daily Record
                         PD     Pickup and Delivery Charges
                         PC     Purchase Card Form
                         SS     Purchase Card Site Parameter

                      Select Enter New Request Option: 10 10-55 PSC Form
                      SITE: Hines Development System//
                      Select STATION NUMBER:    499    SUPPORT ISC
                      Select OBLIGATION NUMBER: ??

                         Choose from:
                         499-A20003        11-24-95    1358   Cancelled Order
                                    FCP:   910     $   0.00
                         499-A20010        01-04-00    1358   Order Not Completely Prepared
                                    FCP:   910     $   0.00
                         499-A20012        07-01-97    1358   Obligated - 1358
                                    FCP:   910     $   2000.00

                      Select OBLIGATION NUMBER: 499-A20012 <Enter> 07-01-97 1358    Obligated - 1358
                                   FCP: 910     $ 2000.00
                      1358 Balance is $ 259.79
                      This will Create a PSC 10-55 Do you wish to Continue? Yes// <Enter>     (Yes)
                      Select PROSTHETIC PATIENT: PROSPATIENT,ONE <Enter> PROSPATIENT,ONE 1-1-30
                      453890765
                       NO     PILL
                       Enrollment Priority:            Category: IN PROCESS    End Date:

                                    *** Patient Requires a Means Test ***
                                    Primary Means Test Required from FEB 13,2002
                               ...OK? Yes// <Enter>   (Yes)
                               HINES, IL


                                                                                      Continued on next page




Revised August 2011                        Prosthetics Basics User Manual                                 78
10-55 PSC Form (10), Continued


Screen                *Comments on file
(continued)           Current Disability Codes are:

                      COS/B          EMPLOYEE       NSC
                      AMP/LAE        SC VIETNAM     S/C
                      AMP/LAE        SC VIETNAM     NSC                 Deleted...
                      ORTH/PLS       INPATIENT      S/C
                      *More Disability Codes on File, See Screen 1
                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue:
                      Add/Edit/View Patient PSC? No// y (Yes)
                      Select PSC ISSUE CARD:

                            NAME                                            SERIAL NUMBER
                      1.    TEST ITEM

                      SELECT NUMBER: 1 <Enter>
                      VENDOR:    PROSVENDOR,THREE                          PH:555 555-5555 NO:     3
                      ORD ADD:CORPORATE ORDER ENTRY                      FMS:
                              ANY PARK, IL 60064                      CODE:             FAX:
                               ...OK? Yes// <Enter>       (Yes)

                        TYPE OF TRANSACTION: I <Enter> INITIAL ISSUE
                        PATIENT CATEGORY: 4 <Enter> NSC/OP
                        SPECIAL CATEGORY: 4 <Enter> ELIGIBILITY REFORM
                        PSAS HCPCS:    A4254 <Enter> BATTERY FOR GLUCOSE MONITOR
                        DESCRIPTION OF ITEM (For Vendor): Battery
                        EXTENDED DESCRIPTION:
                          No existing text
                          Edit? NO//
                        QTY: 1// <Enter>
                        UNIT COST: 20 <Enter>
                        UNIT OF ISSUE: JB// <Enter>       JOB
                        REMARKS (2319 and 1358): battery <Enter>
                      EST. SHIPPING CHARGE: 2 <Enter>

                      Are you ready to POST to IFCAP and 10-2319 NOW? No// y <Enter> (Yes)
                      Would you like to print the Privacy Act Statement? Yes// n <Enter> (No)
                           Posting Now ...
                           1358 Transaction has been assigned Number: 499-A20012-0226
                           Updated 10-2319
                      DEVICE: HOME// <Enter> TELNET     Right Margin: 80// <Enter>



                                                                                     Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                79
10-55 PSC Form (10), Continued


Letter on file        Below is the letter on file for the 10-55 PSC Form (10).


Sample Letter              DEPARTMENT OF VETERANS AFFAIRS
                           Hines Development System
                           TEST 2
                           HINES, IL 60142


                           PROSVENDOR,THREE                                 In Reply Refer to:   -121
                           CORPORATE ORDER ENTRY                               PROSPATIENT,ONE
                           ANY PARK, IL 60064                                  000-00-0001
                                                                               499-A20012-0226

                           PROSVENDOR,THREE

                           With reference to your request of 02/18/04, authority is granted to
                      repair the appliance described below for the above-named veteran.
                      ..........................................................................
                                             DESCRIPTION OF APPLIANCE OR REPAIR
                                                                                     Unit      Total
                           Item Name                  Serial Number          Qty     Price     Cost

                      ..........................................................................
                           903   TEST ITEM                                    1    $20.00
                                 Battery
                                                      Shipping Charge:              $2.00

                           The total cost, not including mailing cost, will not exceed             $20.00

                           When repairs are completed, please attach the original of this letter to
                           the original copy of your invoice covering repair charges. Your invoice,
                           in original and one copy should then be forwarded to this office for
                           payment.

                           Please retain the duplicate copy of this letter for your files.

                           Sincerely,

                           PROVIDER,FOUR, Chief
                           CHIEF

                           Initiator: PROSPROVIDER1,ONE        REF: 578           ADP FORM 10-55




Revised August 2011                      Prosthetics Basics User Manual                                     80
2914 Eyeglass Record (29)


Description           From the Purchasing (PU) Menu and the Enter New Request (EN) Menu, you
                      can access the 2914 Eyeglass Record (29). This will create a VAF 10-2914
                      eyeglass record and post to the patient's VAF 10-2319 and VAF 1358 obligation.


Enter New                24     2421 Form
                         25     2520 Transaction without printing 10-55
Request Menu             10     10-55 PSC Form
                         29     2914 Eyeglass Record
                         NF     Create a No-Form Daily Record
                         PD     Pickup and Delivery Charges
                         PC     Purchase Card Form
                         SS     Purchase Card Site Parameter

                      Select Enter New Request Option: 29 <Enter>        2914 Eyeglass Record




2914 Eyeglass         SITE: Hines Development System//     <Enter>
                      Select STATION NUMBER: <Enter>      499
Record Screen         Select OBLIGATION NUMBER:     499-A20012 07-01-97 1358    Obligated - 1358
sample                             FCP: 910      $ 2000.00 <Enter>
                      1358 Balance is $ 237.79
                      This will Create an EYEGLASS 10-2914 Do you wish to Continue? Yes// <Enter>
                      (Yes)
                      Select PROSTHETIC PATIENT:     PROSPATIENT,ONE    HINES, IL      1-1-30
                      000890765
                          NO     PILL

                      *Comments on file
                      Current Disability Codes are:
                      COS/B          EMPLOYEE         NSC
                      AMP/LAE        SC VIETNAM       S/C
                      AMP/LAE        SC VIETNAM       NSC                    Deleted...
                      ORTH/PLS       INPATIENT        S/C

                      *More Disability Codes on File, See Screen 1
                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue:
                      <Enter>


                                                                                       Continued on next page




Revised August 2011                     Prosthetics Basics User Manual                                    81
2914 Eyeglass Record (29), Continued


Screen sample
                      Enter a screen number (1-8) OR '^' TO EXIT.
(continued)                Select one of the following:
                                1         PATIENT DEMOGRAPHICS
                                2         CLINIC ENROLLMENTS/CORRESPONDENCE
                                3         ENTITLEMENT INFORMATION
                                4         APPLIANCE TRANSACTIONS
                                5         AUTO ADAPTIVE INFORMATION
                                6         CRITICAL COMMENTS
                                7         ADD/EDIT DISABILITY CODE
                                8         HOME OXYGEN ITEMS

                      Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue:
                      <Enter>
                      VENDOR:    PROSVENDOR,THREE                        PH:555 555-5555 NO:     3
                      ORD ADD:CORPORATE ORDER ENTRY                 FMS:
                              ANY PARK, IL 60064                 CODE:             FAX:

                               ...OK? Yes// <Enter>     (Yes)

                      ITEM (for AMIS): ?? <Enter>
                             Choose from:
                         59            EYEGLASSES
                         10000            EYEGLASSES

                      ITEM (for AMIS): 59 <Enter>         EYEGLASSES
                               ...OK? Yes// <Enter>     (Yes)

                        TYPE OF TRANSACTION: I <Enter>   INITIAL ISSUE
                        PATIENT CATEGORY: NSC OP <Enter>
                        PSAS HCPCS:    A4254 <Enter>    Eyeglass
                        BRIEF DESCRIPTION: Eyeglass for a stigmatism <Enter>
                        QTY: 1// <Enter>
                        UNIT COST: 29.99 <Enter>
                        UNIT OF ISSUE: ea <Enter>        EACH
                        REMARKS (2319 and 1358): Ordered eyeglasses <Enter>
                      EST. SHIPPING CHARGE: 3.50 <Enter>

                      Are you ready to POST to IFCAP and 10-2319 NOW? No// y <Enter>    (Yes)
                           Posting Now ...
                           1358 Transaction has been assigned Number: 499-A20012-0227
                           Updated 10-2319




Revised August 2011                    Prosthetics Basics User Manual                                82
                                 Appendix A – Online Help


Question Mark         You can view online descriptive help for menus, options, and prompts. You can
Help                  enter one, two, or three question marks to get extended online help in Prosthetics.


? (Single             Entering a single question mark at a prompt provides you with a single line of
question mark)        standard help.


?? (Double            Two question marks entered at a prompt provide you with a list of choices
question mark)        appropriate to the prompt where you entered the question marks.
                      SITE: Hines Development System// ?? <Enter>

                         Choose from:
                         ATLANTA VAMC                                        508
                         CORKWELL VAMC                                       500
                         HINESTEST                                           998
                         Hines Development System                            499
                         SAN ANTONIO VAMC                                    671
                         ZZOJ VAMC VAMC                                      991

                      SITE: Hines Development System//



Menu Options          You can enter three question marks to view Menu option descriptions.


??? (Triple           Entering three question marks provides you with a brief description and a synonym:
question mark)
                         24      2421 Form
                         25      2520 Transaction without printing 10-55
                         10      10-55 PSC Form
                         29      2914 Eyeglass Record
                         NF      Create a No-Form Daily Record
                         PD      Pickup and Delivery Charges
                         PC      Purchase Card Form
                         SS      Purchase Card Site Parameter

                      Select Enter New Request Option: ??? <Enter>

                      '10-55 PSC Form'     Option name: RMPR 10-55     Synonym: 10
                           This will create a new FL 10-55 form and post purchasing data to
                      patient's VAF 10-2319 record and update the Service's VAF 1358 obligation.

                      '2421 Form'     Option name: RMPR 2421     Synonym: 24
                           This option will create a new VAF 10-2421 form, post to the patient's
                           VAF 10-2319, and update the VAF 1358 obligation.

                      '2520 Transaction without printing 10-55'     Option name: RMPR 2520
                      Synonym: 25
                           For VAF 10-2520 PSC transactions that are under $300.00 and do not have
                      and FL 10-55. It will then post to the VAF 1358 and patient's VAF 10-2319
                      record.




Revised August 2011                      Prosthetics Basics User Manual                                     83
                                    Appendix B - Glossary


Ad Hoc                An Ad-hoc has a specific purpose. Example: MS Access ad hoc query done to
                      obtain specific data.


AMIS                  Automated Management Information System.


Authorization         An estimated payment that will be applied to the 1358.


Control Point         The division of monies to a specified service, activity, or purpose from an
                      appropriation. This is a financial element, existing only in IFCAP, that corresponds
                      to the ACCS number in FMS.


Cost Center           Subsections of Fund Control Points. Cost centers allow fiscal staff to create total
                      expense reports for a section or service, and requestors to assign requests to that
                      section or service.


DCT                   Document Confirmation Transactions


Default               A normal or suggested response to a prompt that is provided by the system.


Detailed              A description of the item and/or where it can be found within a location.
Inventory ID


DSS                   Decision Support System


FMS                   Financial Management System (FMS), which has replaced CALM as the primary
                      accounting system for administration appropriations.

                      FMS has a comprehensive database that provides for flexible on-line and/or batch
                      processing, ad-hoc reporting, interactive query capability and extensive security.

                      FMS is concerned with budget execution, general ledger, funds control, accounts
                      receivable, accounts payable and cost accounting.

                                                                                        Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                      84
FPDS                  Federal Procurement Data System.


Fund Control          CALM accounting element that is not used by FMS.
Point


Funds                 A group of fiscal options that allow the budget analyst to distribute funds to control
Distribution          points and track budget distribution reports information.


GIP                   Generic Inventory package.


Grouper               The grouper counter is used to associate multiple entries in file 660, Record of
Counter               Appliance/Repair, to a single patient. A post-init routine initially sets the counter for
                      you at 99999999, then counts backwards. Do not edit this number.


HCPCS                 Healthcare Financing Administration Common Procedure Coding System. A code
                      that represents an item or service.


IFCAP                 Integrated Funds Distribution, Control Point Activity, Accounting and Procurement.


Item File             A listing of items specified by A&MM as being purchased repetitively. This file
                      maintains a full description of the item, related stock numbers, vendors, contract
                      numbers, and a procurement history.


Item History          Procurement information stored in the ITEM file. A history is kept by fund control
                      point at the time of request.


Item Master           A computer-generated number used to identify an item in the ITEM file.
Number


Location              A specific area that contains prosthetic stock.


MCCR                  Medical Care Cost Recovery

                                                                                          Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                       85
No-Form Daily         The no-form type of purchasing transaction is used to record purchases from local
Record                Durable Medical Equipment (DME) contracts. Not all VAMCs use this type of
                      contract. Items such as hospital beds, bath transfer equipment, etc. are examples of
                      types of equipment purchased from a DME on this form.


NPPD                  National Prosthetics Patient Database


Obligation            The commitment of funds. The process that Fiscal Service completes to set aside
                      monies to cover the cost of a purchase order.


Obligation            The C prefix number that Fiscal Service assigns to the 1358.
Number


Patient               The patient’s service connection and patient status:
Category              SC/OP
                      SC/IP
                      NSC/IP
                      NSC/OP


Pickup and            Pickup and delivery charges must be included in AMIS information. This computer
Delivery              form records pickup and delivery charges when a local vendor is required by contract
Charges Form          to pickup/deliver prosthetic items at a veteran’s home.


PSAS Item             Prosthetic Sensory Aids Service (PSAS) item that can be issued to a patient. There
                      may be multiple PSAS items associated with one HCPCS:

                      Sling, arm extra large
                      Sling, arm medium
                      Sling, arm small


PSC                   Prosthetic Service Card


Purchase Order A government document authorizing the purchase of goods or services within the
               terms indicated.

                                                                                       Continued on next page




Revised August 2011                      Prosthetics Basics User Manual                                      86
Purchasing            A&MM employees legally empowered to purchase goods and services from
Agents                commercial vendors.


Reference             Also known as the transaction number. The computer-generated number that
Number                identifies a request. It is comprised of the station number, fiscal year, quarter,
                      control point, four-digit sequence number.


Re-order Level        A level at which time a stock item should be re-ordered. A mailman message will
                      appear daily indicating the re-order level has been reached.


Short                 The nomenclature that identifies the item in the ITEM MASTER file. It is restricted
Description           to three-to-sixty characters and consists of what the item is, what kind of item, and
                      the size of the item (e.g., glove-surgical medium).


Site Parameters       Information such as station number, cashier address, billing address, etc., that is
                      unique to your station.


Source                The distribution for the stock, either VA or Commercial.


Transaction           Any action that affects a bill or an account. All transactions are numbered
                      sequentially and may be examined individually.


Transaction           The number of the transaction that funded a control point. It consists of the station,
Number                fiscal year, quarter, control point sequence number.


Type of               A first-time issue, a repair of a previous issue, a spare, or a replacement of a stock
Transaction           item:
                      Initial = I
                      Repair = X
                      Spare = S
                      Replace = R


Unit of Issue         How the item is issued, e.g., box, each, bottle, etc.

                                                                                          Continued on next page




Revised August 2011                       Prosthetics Basics User Manual                                       87
VA                    The Department of Veterans Affairs, formerly called the Veterans Administration.


VA Form               This VA form is used to record estimated obligations or changes in estimated
4-1358                obligations.


VA Form               Each time a patient receives medical equipment, supplier or services from
10-2319               Prosthetics Service, the item purchased is recorded on this form (Record of
                      Appliance/Repair). This is an overall list of all appliances/repairs purchased for a
                      veteran.


VA Form               This is the main purchasing authorization and invoice form for items or services
10-2421               issued by Prosthetics Service.


VA Form               This form is used to authorize repairs for prosthetic items/appliances prior to the item
10-2520               being sent to a vendor for repair.


VA Form 10-           Appointment roster and action sheet for clinics.
2527


VA Form               Eyeglasses are authorized for purchase on this form.
10-2914


VA Form               This repair authorization form letter is used by Prosthetics Service to authorize
10-55                 repairs of prosthetic items/appliances sent directly to the vendor by the veteran,
                      without prior Prosthetic Service approval on VA Form 10-2520.


VA Form               This form tracks cumulative active prosthetics disability codes for AMIS
10-7306d              calculations.
(AMIS)


VA Form 2237          This form is used to request goods and services by a service/section, through
                      A&MM.


VA Form               This form keeps track of purchases that are used with a purchase card. Form 1358 is
2421PC                no longer available when a purchase card is used.

                                                                                         Continued on next page


Revised August 2011                      Prosthetics Basics User Manual                                      88
Vendor                The company from which the item is purchased.


Vendor File           An IFCAP file (440) of vendors that the facility conducts business. This file
                      contains ordering and billing addresses, contract information, FPDS information, and
                      telephone numbers.


VISTA                 Veterans Health Information Systems and Technology Architecture, formerly
                      Decentralized Hospital Computer Program of the Veterans Health Administration
                      (VHA), Department of Veterans Affairs (VA).

                      VISTA software, developed by the VA, is used to support clinical and administrative
                      functions at VA Medical Centers nationwide. It is written in M and, via the Kernel,
                      runs on all major M implementations regardless of vendor.

                      VISTA is composed of packages that undergo a verification process to ensure
                      conformity with name spacing and other VISTA standards and conventions.




Revised August 2011                     Prosthetics Basics User Manual                                   89

				
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